This thesis explores psychological factors of End-Stage Renal Disease (ESRD) treatments across three chapters. A systematic literature review explores the impact of ESRD treatments on body-image. The review clearly highlighted a significiantly higher rate of body-image dissatisafaction/disturbance in the ESRD population compared to the general population. The majority of studies, which compared treatment modalities, found that body-image dissatisfaction was significantly greater in the haemodialysis population, than peritoneal dialysis or kidney transplant populations. A strong association was also found between body-image and psychological distress. However, there were numerous methodological concerns that should be considerd when interpreting the findings. An empirical study investigates the implications of anxiety, depression and attachment styles on adherence to ESRD treatment. A significant correlation was found between age, depression and fearful-insecure attachment styles. Collectively, age, depression and attachment accounted for a significant proportion of variance in treatment adherence. However, attachment was not independently predictive. The clinical recommendations of the study include that depression should be routinely screened for within services. The results justify the need for further research on attachment and suggests that services should be mindful of attachment styles when supporting patients who are non-adherent to treatment. The final chapter explores the impact of the findings from the review and empirical papers. This chapter considers the relationship between the findings and theoretical understanding, as well as the implications for future research. Additionally, the chapter explores the clinical implication of the findings, including the continued need for psychology provision within renal services. Finally, the chapter contains personal reflections of the process of completing the thesis.