The finding that the FCGR3A*T allele is associated with the global lupus phenotype but that homozygosity for the FCGR3A*G allele is a risk factor for ESRD suggests that genetic factors influencing the tempo and severity of end organ disease progression may be distinct from those determining initial disease susceptibility. The gene discussed is FCGR3A; the disease is systemic lupus erythematosus.