In this study, the perceived quality of life (QOL) of 215 patients with and stage renal disease (ESRD) was examined. A LISREL model describing the patients' perceptions of their QOL was tested and, after some revisions, was found to be consistent with the data (chi 2 = 33.76, df = 25, p = 0.113). QOL was measured by: the Self-Anchoring Striving Scale, the Index of Well-Being, and the Time Trade-Off Technique. The model includes the patients medical characteristics, their health status, functional status, support and outlook. Outlook, functional status and treatment modality had significant direct effects on QOL. Support influenced QOL through the mediating variable, outlook. This study suggests that a theoretical reexamination of the measurement structure of QOL is warranted.