The evolution of nephrology practice in Egypt: legacy, current challenges, and future directions-a narrative review.

Egypt, home to over 114 million people, hosts a diverse and expanding nephrology landscape, anchored by leading academic institutions and tertiary care centers that provide services across the full spectrum of kidney disease-from acute kidney injury (AKI) and chronic kidney disease (CKD) to dialysis and transplantation. Some centers have earned international recognition for their scientific contributions and attract referrals from across the region. Notwithstanding the range of services offered, the Egyptian healthcare system-which includes insurance-based, commercial, and governmental models-faces significant obstacles, such as unequal access to care, a lack of adequate data infrastructure, and resource limitations. This narrative review, authored by a multidisciplinary team of Egyptian nephrology experts, provides a comprehensive overview of nephrology care in Egypt, highlighting current strengths, identifying key challenges, and offering future-oriented solutions to advance kidney health nationwide. It aims to serve as a roadmap for policymakers, stakeholders, clinicians, and researchers committed to improving nephrology care delivery in Egypt and shaping a more equitable, enhanced, and sustainable future.