Chronic kidney disease (CKD) is a public health problem in Mexico, causing 25% of deaths related to diabetes mellitus (DM) and 28% related to hypertensive heart disease. In 2008 CKD reached the highest incidence of end-stage renal disease in the world. Diabetes mellitus is the main risk factor associated with CKD in Mexican population; however, heavy metals such as lead, arsenic, cadmium and mercury have been associated to nephropathies. In Mexico there are still high levels of these compounds in occupational and environmental settings; therefore, chronic exposures to these metals persist. In this review we approach to the main mechanisms of action of these metals in the body and its renal effects, as well as information about the sources of exposure to these chemical risks, the relationship between exposure to heavy metals and CKD, coupled with the economic and social consequences of this disease.