Psychosocial character traits and coping skills were examined in 12 children with end-stage renal failure. Six of the children were maintained on in-center hemodialysis and 6 were treated with home peritoneal dialysis. All of the patients felt a lack of ability to control their lives. The incidence of anxiety, depression, and hostility did not appear to vary from a population of healthy adolescents. Personal and social adjustment scores were, on average, on the 20th percentile. Coping skills appeared to be most influenced by the mode of dialysis treatment. Home peritoneal dialysis patients utilized self-reliance as a coping process more often than their counterparts on hemodialysis. We conclude that children maintained on chronic dialysis therapy demonstrate reasonable psychological adjustment with some differences in social and emotional functioning when compared with healthy children, and that the type of treatment chosen may influence the development of certain coping skills.