Odisha, located on the east coast of India covers 155,707 sq. km and has a population of approximately 40 million, primarily residing in rural areas. Despite its wealth in water, forests, and minerals, Odisha struggles with poverty and is impacted by frequent natural disasters such as droughts and cyclones. The prevalence of tropical diseases such as malaria and cholera is high, alongside inherited disorders such as sickle cell disease. The state has developed nephrology services since 1960s. Currently, about 900 dialysis machines operate across Odisha. Chronic kidney disease of unknown etiology remains a critical issue, particularly in areas such as Narsinghpur. Efforts are ongoing to improve healthcare infrastructure and research to address these challenges effectively.