Social support is a concept recognizing patients exist to varying degrees in networks through which they can receive and give aid, and in which they engage in interactions. Social support can be obtained from family, friends, coworkers, spiritual advisors, health care personnel, or members of one's community or neighborhood. Several studies have demonstrated that social support is associated with improved outcomes and improved survival in several chronic illnesses, including cancer and end-stage renal disease (ESRD). The mechanism by which social support exerts its salutary effects are unknown, but practical aid in achieving compliance, better access to health care, improved psychosocial and nutritional status and immune function, and decreased levels of stress may all play key roles. Few data exist regarding social support in patients with ESRD and chronic renal insufficiency, but links between social support and depressive affect and quality of life have been established. Interventions that enhance social support in ESRD patients should be evaluated.