The increase in prevalence of end-stage renal failure continues despite at least two decades of intensified renal protection programs including optimal blood pressure control, suitable glycemic control in diabetic patients, smoking cessation (5-9), and the broad use of angiotensin converting enzyme inhibitors or renin-angiotensin-aldosterone system blockers in both non-diabetic and diabetic chronic renal failure (9-14). The gene discussed is REN; the disease is stage 5 chronic kidney disease.