There is no doubt that particular occupational exposures may induce acute renal effects. The role of occupational exposure in the development or progression of chronic renal failure, however, is still not clear. Recent epidemiological studies point towards a contributive role of particular occupational exposures in the progression of renal disease. Furthermore, some observations in the 1994-1995 literature suggest a primary or secondary role, or both, of new substances such as silicon-containing compounds in the development of anti-neutrophil cytoplasmic antibody-positive rapidly progressive glomerulonephritis and Wegener's granulomatosis. Finally, studies suggesting a particular sensitivity of the diabetic kidney towards the damaging effects of certain occupational exposures deserve confirmation.