Climate change and contamination by microparticles in the atmosphere, rivers, and seas by heavy metals and other toxic substances are being considered as contributing factors for the appearance of chronic kidney disease (CKD) and its risk factors such as high blood pressure, diabetes, and obesity, as these substances are also endocrine disruptors. These nephrotoxic elements produce mitochondrial dysfunction, oxidative stress, and activation of the inflammatory phenomenon. Acute kidney injury is a common denominator of nephrotoxic substances and can evolve into chronic kidney disease and accelerate its progression. Therefore, follow-up should be carried out after an acute renal episode in these patients. Heavy metals (Hg, Cd, Pb, As), agrochemicals, and aristolochic acid, present in some herbal therapy medications, represent risk factors for the development of CKD, as occurs in different areas of the world and whose origin is still unknown. Traditional indicators such as the calculated measurement of glomerular filtration rate using serum creatinine and the albumin/creatinine ratio do not accurately determine tubulointerstitial renal lesions, which are generally caused by toxins. Other types of biomarkers of inflammation, fibrosis, and progression of kidney disease should be implemented, which are much more appropriate for the diagnosis and monitoring of this type of CKD due to nephrotoxins.