The literature shows that many complications including psychosocial, sexual and economic are associated with dialysis. However few studies have been conducted from the patients' perspective or have examined the pre-dialysis phase of established renal failure. The aim of this qualitative study was to explore the perceptions and experiences of pre-dialysis patients. Ten patients were interviewed, on one occasion, prior to starting dialysis. The interviews were conducted in a semi-structured manner in accordance with pre-defined interview topics. The findings of the study highlighted that participants had no clear expectations of dialysis treatment and generally expressed a sense of fatalism and lack of knowledge. This was highlighted by the main emergent theme, response to information. It became clear that most of the patients had received information, but had either misinterpreted, or been unable to absorb it. A number of specific issues including provision, quantity, interpretation and the timing of information appeared to be linked to the participants' inability to gain knowledge. These study findings highlight the importance of a patient centred, flexible education programme to enable patients to absorb and accurately interpret information.