Although the number of children with kidney failure is relatively small, the disease carries a high burden for both children and their families that persists throughout the lifespan. Eleven studies, published since 1980, which examine how families adjust to having a child with chronic kidney failure, are reviewed. Parents tend to have high levels of stress, depression, and anxiety, and those with lower socioeconomic status have more difficulty adjusting. Parents describe uncertainty, social isolation, and increased care-taking duties us contributing to the burden of the disease. Future research priorities are identified. Measuring adjustment and developing interventions may ultimately ...