Behavioral contracting to improve dietary compliance in chronic renal dialysis patients

End stage renal disease is the most severe stage of kidney failure. Hemodialysis or kidney transplants are required to insure patient survival. When dialysis treatment is used, patients experience dietary restrictions and consequently must limit fluid and food intake to compensate for the lack of kidney functioning. Two case studies are presented to demonstrate the effectiveness of behavioral procedures in improving compliance to dietary restrictions in chronic fluid overloaders. A contracting procedure between medical staff and the patients, and contingent staff praise for meeting weight standards, led to lower intersession weight gain. Continuous follow-up assessment indicated long term maintenance of treatment effects for these patients.