The kidneys make urine, filter substances from the bloodstream, and are important in maintaining body chemistry. Permanent damage to the kidneys is called chronic kidney disease (CKD). Some common medical conditions that can cause CKD are diabetes, hypertension (high blood pressure), inherited kidney diseases, diseases of the kidney tissue itself, and chronic obstruction of the bladder. Some medications can have adverse effects that damage the kidneys. The kidneys also may be permanently impaired by a severe illness, such as heart failure or sepsis. Chronic kidney disease can progress to complete loss of kidney function, known as end-stage renal disease (ESRD). The September 12, 2007, issue of JAMA includes an article about CKD and ESRD.