Diabetic nephropathy is the commonest cause of ESRD in industrializedcountries. A series of surveys of DM have been performed in Egypt andrevealed a difference between urban and rural areas in prevalence ofDM. The aim of our study was to estimate the difference in prevalence ofdiabetic nephropathy as a cause of ESRD in urban and rural areas inEgypt. Two (urban and rural) groups of ESRD patients were evaluatedfor evidence of diabetic nephropathy through a review of each patientdata before and during dialysis treatment. We found that diabeticnephropathy is more prevalent in urban (18.7%) than in rural areas(11.8%) as a cause of ESRD in Egypt.