Hemodialysis and kidney transplantation are often accompanied by psychological problems that can affect the medical course oftbe illness. The most frequent problems include depression, noncompliance u'itb diet and medication, and sexual dysfunction. Approximately one-fourth ofdialysis patients are depressed at any one time, and 2.7 percent oftransplant patients experience affective psychosis. In addition, about 1 percent of the dialysis patients u'ill commit suicide. Following transplantation body image problems may occur, primanly arising from the introduction ofthe new organ and from the disfiguring side effects of steroid medication. The author summarizes the pertinent psychiatric literature and treatment modalities available.