Chronic kidney disease causes the organs to function less effectively
The identification of 20 genes which could help explain the causes of kidney disease could one day "revolutionise" treatment, researchers say.
Chronic kidney disease affects about one in 10 adults and can require dialysis or even an organ transplant.
The genes identified by the international team of researchers control kidney functions such as filtering waste from the blood.
Experts said the Nature Genetics study was "a great breakthrough".
Chronic kidney disease (CKD) is a long-term condition in which the kidneys progressively lose their function.
People tend not to notice symptoms, which can include swollen ankles and hands or blood in the urine, until the condition is advanced.
It is linked to ageing - about one in five men and one in four women aged between 65 and 74 will have some degree of CKD.
The most common cause of CKD is damage caused by other long-term conditions, such as diabetes and high blood pressure.
It was known there was a genetic component to the disease, but not which genes were involved.
In this study, an international team of scientists, including researchers at the University of Edinburgh, looked at the genes of nearly 70,000 people across Europe.
They found 13 new genes that influence renal function and seven others that affect the production and secretion of creatinine - a chemical waste molecule that is generated from muscle metabolism and filtered through the kidneys.
Dr Jim Wilson, a geneticist at the University of Edinburgh who worked on the study, said: "This work could revolutionise the treatment of kidney disease in the future - but this will take some time.
"It's a very critical first step towards a completely new understanding of the biology behind CKD. Transferring what we've found into clinical benefits will take some years."
Charles Kernahan, chief executive of the charity Kidney Research UK, said "These are still early days but it is truly a great breakthrough.
"No-one knows who will be affected or when kidney disease may strike next, so even more research needs to be funded to help us tackle this challenge."