A search for renal failure genes is being conducted in African American sib pairs concordant for end-stage renal disease (ESRD) recruited predominantly from the dialysis population in the Southeastern United States. Family history data is being collected in patients from more than 250 individual dialysis units. Patients with polycystic kidney disease, Alport's Syndrome and confirmed urologic disease are excluded. The study employs a candidate gene strategy initially, followed by a genome-wide search for linkage between polymorphic markers and the phenotype "ESRD."