The identification of genetic linkage between polymorphic markers and common kidney diseases, including focal and segmental glomerulosclerosis and diabetic nephropathy, clearly demonstrates that inherited factors contribute to renal failure susceptibility. These breakthroughs reveal the powerful contribution that molecular genetic techniques can make in the search for inherited factors that initiate renal failure and lead to its progression. Additionally, the environmental factors predisposing to nephropathy will be more readily detectable when evaluated in genetically similar populations. This manuscript reviews the developments in genetic epidemiology and molecular genetics of chronic renal failure.