Psycho logical aspects of renal replacement therapy have been studied by numerous researchers. However, many of these studies are of poor quality, involve small study groups, or focus only on a narrowly defined hypothesis. Due to a lack of general conceptual framework, it is difficult to generalize and inter pret the data, especially in terms of the cause-and-effect relationship. Further research is required to assess how patients with end-stage renal disease cope with dialysis-related stress. Particular emphasis should be placed on the preparation of experimental studies and clinical trials with a longer follow-up.