Cass : A 49-year-old house-wife, Diagnosis : Chronic renal failure and hypertension, Chief complaints : headache, anorexia, nausea, vomiting generalised fatigue. Present history : Since Nov. 1983,she complained of fatigue and was diagnosed as suffering hypertension & chronic renal failure and treated by hemodialysis since Jan. 7 1984. Since March 1st, of the same year, she has been treated with hemodialysis twice a week on an outpatient basis in our hospital. On Aug. 22nd, she gained weight and her CTR increased. We thought it was because of insufficiency of water control and placed her on a 3-time/week treatment regimen. Her dry weight over 5% and insufficient control of water balance contintinued. In Sept. 1985,we instituted guidance to change her lifestyle so that the Adult egostate factor on Egogram would elevate. In Sept. 1986 we again evaluated her Adult ego state factor and found an improvement in the presence of a 4.9% in dry weight. Future efforts will be made to expand our series of treatment in an attempt to substantiate the results obtained in this case study. Disussion : We found that there is a 5% difference between the well controled group and the poorly controled group. The Adult egostate factor by Egogram of this case was low and we thought that we would be able to assist her by promoting this function. However, control was not easy because her life style from childhood was more physically oriented than mentally. She was marrid with a plumber and present is involved in a very busy life with work and house care. We advised her to decelerae her life style to allow more time to spend leisurely and to think about alleviating her symptoms. Therapy was continued for about 1 year and we were able to obtain good clinical results. We learned that management of these specific patients and their symptomology is not only time consuming but also very complex. Thus, we, as clinicians attermpting to help these patients with a multiplicity of symptoms, might be able to use the results of this case study as a guideline in the management of these patients.