African Americans are disproportionately represented among patients with end-stage renal disease (ESRD). ESRD is managed with a strict routine that might include regular dialysis as well as dietary, fluid intake, and other lifestyle changes. In a disease such as this, with such disruptive treatment modalities, marriage, specifically, and its ties to well-being have the potential to significantly affect adherence to medical treatment and lifestyle recommendations as well as downstream health outcomes such as disease progression and mortality. The authors used data from the Dialysis Morbidity and Mortality Study, Wave 2, of the U.S. Renal Data System Database, a prospective study of 4,000 ESRD patients selected from a random sample of 25% U.S. dialysis facilities, to investigate these research questions. They found that married African American ESRD patients had marginally better outcomes on several clinical and psychosocial measures, which they hypothesize may be attributable to the instrumental and emotional support conferred by marriage. (Contains 5 tables.)