Social determinants of health and limited access to medical care contribute to underdiagnosis and late presentation of chronic kidney disease (CKD). Rural areas face unique challenges in providing optimal care for patients with CKD due to poverty, limited healthcare access, and geographical barriers. This review will address the challenges of caring for rural patients with CKD and discuss potential strategies to increase healthcare equity. Furthermore, we will examine rural disparities in patients with CKD, patients with kidney failure on in-center or home dialysis, and patients with kidney transplants, highlighting the need for targeted interventions to address these disparities.