End-stage renal disease (ESRD) represents one of the most striking examples of health disparities in the United States. Compared with white Americans, black Americans are nearly 3 times more likely to develop ESRD during their lifetime.1-3 In this issue of AJKD, Albertus et al2 suggest that other racial and ethnic minorities are also at increased risk for ESRD, and that these disparities have changed little in the past 10 years.