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The incidence and prevalence rates of end-stage renal disease patients in Albania have increased after the fall of the communist regime, which happened in 1990. Renal replacement therapy in Albania started with the chronic hemodialysis program in 1985 at the University Hospital Center “Mother Teresa”. The program was created mainly to treat the head of the state, who suffered from advanced diabetic nephropathy. From a country with an extremely poor economy, which meant that no more than just a few patients could be kept alive on renal replacement therapy, Albania has undergone profound political and economic changes. Besides, Nephrology in Albania has achieved immense improvement in the last two decades. The possibility of treating every ESRD patient with RRT became a reality in the last decade, and this is considered our outstanding success. Currently, we have a well-established living donor transplantation as well as Peritoneal Dialysis program, which represent promising advances in both modalities. We believe that our national program for early detection and prevention of CKD progression and associated complications could help us in improving patient outcomes and reducing the impact of CKD on our limited health-care resources.