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This study examined the marital profiles of couples with one member on dialysis. These profiles were then compared to the marital profiles of nondialysis, nondistressed couples to determine if there were differences in ratings of marital satisfaction and in the behavioral correlates associated with marital distress. Four marital inventories were administered to 15 dialysis and to 15 nondialysis, nondistressed couples. These instruments included the Spouse Observation Checklist, Marital Satisfaction Inventory, Areas of Change Questionnaire, and the Locke-Wallace Marital Adjustment Scale. The results of 2 x 2 Analyses of Variance showed that dialysis couples could be differentiated from nondialysis, nondistressed couples on a number of clinically relevant scales. Specifically, dialysis couples exchanged higher rates of displeasing behaviors and lower rates of pleasing behaviors; experienced greater marital distress on nine out of eleven clinical scales reflecting behavioral correlates of distress; desired more change, perceived that more change was desired of them, had greater perceptual accuracy; and, rated their marriages being less satisfying. Implications of these findings for treatment planning followed.