Kidney disease is a global public health problem; affects more than 750million persons worldwide. The burden of kidney disease varies substantially across the world, as does its detection and treatment. Emerging evidence suggests that developing countries have a similar or even greater kidney disease burden than developed countries. In many settings, rates of kidney disease and the provision of care are defined by socioeconomic, cultural, and political factors, leading to significant disparities, even in developed countries. These disparities exist across the spectrum of kidney disease -prevention, screening, care and treatment. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease. This editorial highlights these disparities and emphasizes the role of public policies and organizational structures in addressing them. We outline opportunities to improve our understanding of disparities, the best ways to address them, and how to streamline efforts toward achieving kidney health equity across the globe.