Incorporating pharmacists into multidisciplinary teams in the outpatient ambulatory care and inpatient acute care settings can circumvent major drug-related problems through the process of medication therapy management (MTM), in which the pharmacist’s care plan includes optimal evidence-based medication, goals of therapy, and, most important, ensuring that appropriate follow-up is carried out. Chronic kidney disease (CKD) patients present with comorbid disease states with often-complex pharmacotherapeutic regimens that can be difficult not only for the patient, but for the prescribers as well. This review evaluates medication-related problems associated with CKD, nonadherence issues, medication reconciliation, and the contributions pharmacists provide through MTM.