End stage renal disease (ESRD) has a profound impact on the quality of life and survival of a growing number of Canadians. Although individuals from various cultural and ethnic groups are represented in the ESRD population receiving renal replacement therapy, there is data indicating that certain groups are at increased risk of developing renal failure. The underlying reason for this is not entirely clear, but an interaction between genetic factors, environmental influences and socioeconomic status has been suggested. In Canada and other industrialized countries, common causes of ESRD include diabetes and hypertension, both of which are known to be responsive to lifestyle modification and preventative interventions. Treatments for these conditions are costly, both to the individual and society. One approach to reducing the social and economic burden of organ damage may be to create partnerships between multidisciplinary tertiary care teams and community groups interested in health promotion. A liaison between specialists, general practitioners, health promoters with the knowledge of delivering culturally based education to groups, and lay people in the community may be an effective means to reducing the burden of ESRD on certain ethnic groups in Canada and other Western countries.