Kidney disease is generally considered an incident phenomenon, with transition from diseased kidney to chronic and eventually kidney failure. Early recognition and treatment of failing kidney can save many years of life and resources for individuals and economy. This book Who lives, Who Dies with Kidney Failure attempts to highlight how people are challenged by this serious disease that can be described as emotionally exhausting, financially draining, and a lifelong engagement like no other major life threatening illness that shares the rank. With chronic disease ascending the ladder as a killer there is need for serious thinking. How will people with poverty, lower socioeconomic status and certain ethnic groups be protected against known risk factors diabetes, hypertension, obesity and others? Urgent attention need to be paid to these environmental factors and further research is needed to fully understand these factors. With 20th century marked great medical advancements and surprisingly the book has captured nuances of early adopters who had a visionary approach to manage and even curtail disease. But accidental cases or late detections were simply ruining their winning game by pulling them down into a compromised state. This century will write a new story. How can we know how much went into developing the story till now? Have we recognized personal tragedies and victories for handling such a complex disease? The foundation of the new story lies there.