End-stage renal disease (ESRD) disproportionately affects racial/ethnic minority populations in the United States, whereas the prevalence of ESRD risk factors such as diabetes continues to increase. Using data from the US Renal Data System, we examined trends in ESRD incidence, including ESRD caused by diabetes or hypertension. We determined the total number of persons in the United States by race/ethnicity who began treatment during 1995 to 2005 for ESRD and for ESRD with diabetes or hypertension as the primary diagnosis. Incidence rates were calculated by using census data and age-adjusted based on the 2000 US standard population. Joinpoint regression was used to analyze trends. Overall, during 1995 to 2005, the age-adjusted ESRD incidence increased from 260.7 per million to 350.9 per million, but the rate of increase slowed from 1998 to 2005. In the 2000s, compared with the 1990s, the age-adjusted ESRD incidence has continued to increase but at a slower rate among whites and blacks and has decreased significantly among Native Americans, Asians, and Hispanics. The disparity gap in ESRD incidence between minority populations and whites narrowed during 1995 to 2005. Continued interventions to reduce the prevalence of ESRD risk factors are needed to decrease ESRD incidence.