Phipps & Turkington (2001) gave a good overview of the range of psychological difficulties experienced by patients in a renal unit. However, there was one important omission; non-adherence to treatment. Non-adherence to dietary and fluid restrictions by patients receiving dialysis is well recognised and non-adherence to immunosupressant medication following transplantation is now being seen as a major problem. There are several studies showing that at least 20% of all transplant recipients omit some of their immunosuppressants and that non-adherence is a leading cause of premature transplant failure (Reference Schweizer, Rovelli and PalmeriSchweizer et al, 1990). Adherence research in patients with renal and other chronic conditions has indicated the importance of health beliefs (Reference Horne, Myers and MidenceHorne, 1998) and mental state (Reference Bunzel and Laederach-HofmannBunzel & Laederach-Hofmann, 2000) in determining adherence, yet renal staff are likely to have received little, if any, training in the assessment of such areas. Non-adherence to treatment is thus a field in which psychological intervention is likely to make a positive impact and is therefore an area that requires further attention by liaison psychiatrists.