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The Central and Eastern European (CEE) region now consisting of 19 countries with a total population of more than 400 million. From ancient times to recent years the history of this area has been tempestuous with often changing borders, loss of independence and its eventual recovery even after many years. Despite such a complicated history in this region some excellent physicians and scientists were able to establish the basis of modern nephrology. This paper records the development of clinical nephrology and renal replacement therapy in CEE region. Data from 9 countries (Bulgaria, Byelorussia, Croatia, Czech Republic, Hungary, Lithuania, Romania, Serbia & Montenegro and Slovakia) was collected. Mentioned are internationally recognized early nephrologists like: Karl Rokitansky (1804-1878) - Czech origin, famous pathologist; Sergey Zimnicki (1873-1927) - Byelorussian physician, founder of the urine concentration test; Sandor Korany (1866-1944) - Hungarian scientist who described hyposthenuria in chronic renal failure; Stefan Rozenak - Hungarian working on PD problems, or Emerich Ullmann (1866-1897) - Hungarian, one of the pioneers of transplantation. During more recent years other clinicians working in the region (eg. Jan Brod (1912-1985) - Czech nephrologist) developed clinical nephrology and renal replacement therapy in the region. Nowadays in all countries mentioned, strong nephrological centers connected with University Hospitals are present and many new ones are coming into existence in regional and local hospitals. Renal replacement therapy was generally underdeveloped for many years, but after political and economical liberation real progress was achieved in this matter in most of the countries. Nephrologists from CEE region, especially from Czech Republic and Hungary, have been very active organizing many international meetings (ISN, EDTA, ESAO, EDTNA etc) and some of them participate in the boards and councils of these organizations. Summarizing this overview one has to conclude that CEE countries have participated actively in the progress of the modern nephrology, especially during the last century.