Depression In Hemodialysis Patients Research Articles

Prevalence Of Anxiety and Depression In Hemodialysis Patients

Prevalence Of Anxiety and Depression In Hemodialysis Patients

Association of Hyperparathyroidism with Depression and Anxiety Among Chronic Hemodialysis Patients in the Al Baha Region, Kingdom of Saudi Arabia.

Introduction Anxiety and depression are prevalent psychological issues among hemodialysis patients, adversely affecting their well-being and treatment response. The study aims to identify the relationship between these mental health concerns and hyperparathyroidism in chronic hemodialysis patients from the Al Baha Region, Kingdom of Saudi Arabia. Methods This retrospective study included 143 chronic hemodialysis patients aged 18-85 years. Monthly laboratory records for parathyroid hormone (PTH) levels and the Hospital Anxiety and Depression Scale (HADS) for mental health assessment were utilized. Demographic information and the primary causes of end-stage renal disease were obtained through patient interviews. Statistical analyses, including chi-square tests, odds ratio, and significance tests, were performed to assess associations. Results Elevated PTH levels were associated with increased anxiety and depression in hemodialysis patients. Patients with PTH levels >400 pg/ml exhibited higher rates of abnormal HADS scores for anxiety and depression than those with PTH levels <400 pg/ml. Gender differences were evident, with women showing a higher predisposition to anxiety disorders and men having depression. Additionally, patients with PTH levels <150 pg/ml had a significantly higher proportion of the "normal" depression score than those with PTH levels >800 pg/ml. Conclusion The study underscores the association between hyperparathyroidism and adverse mental health outcomes in chronic hemodialysis patients. Maintaining optimal PTH levels plays a crucial role in mitigating anxiety and depression. Gender differences in mental health outcomes highlight the need for tailored interventions. Routine mental health assessments, utilizing tools such as the HADS, are important in the comprehensive care of hemodialysis patients.

Association between handgrip strength and depressive symptoms in patients undergoing hemodialysis: a cross-sectional study from a single Chinese center

BackgroundThe relationship between handgrip strength (HGS) and depression in patients undergoing hemodialysis (HD) was unknown. Therefore, we aimed to clarify this association in a cohort of patients.MethodsHGS was used as a representative indicator of muscle strength and was measured with a handheld dynamometer. Depressive symptoms were assessed with the self-reported Patient Health Questionnaire-9. A multivariable logistic regression model and restricted cubic spline analysis were used to assess the relationship between HGS and depression.ResultsThe prevalence of depression in our study was 34% in 568 Chinese patients undergoing HD. Compared with patients in the lowest tertiles of absolute and weighted HGS, patients in the highest tertiles of HGS had an approximately 59% lower [odds ratio (OR) = 0.41, 95% confidence interval (CI) = 0.24–0.68; OR = 0.41, 95%CI = (0.24–0.69)] prevalence of depressive symptoms after multivariate adjustments. Besides, the risk of depression in hemodialysis patients decreased by 33% (OR = 0.67, 95%CI = 0.53–0.85) and 32% (OR = 0.68, 95%CI = 0.54–0.85) for each standard deviation increase in absolute HGS and weighted HGS, respectively. The prevalence of depressive symptoms decreased with both increasing absolute HGS and weighted HGS after multivariate adjustments (p for trend < 0.05). Furthermore, a linear dose-response relationship was observed between absolute HGS and weighted HGS and the prevalence of depressive symptoms (pnonlinearity>0.05).ConclusionsThis study suggests that lower handgrip strength, a simple and modifiable parameter, is associated with a higher prevalence of depression in Chinese patients undergoing HD. Considering that depression is often unrecognized or underdiagnosed in HD patients, lowered muscle strength should be an important indicator and incentive for medical staff to screen for depression.

The Effects of Auricular Acupressure on Pruritus, Skin Dryness, and Depression in Hemodialysis Patients

Purpose: This study investigated the effects of auricular acupressure therapy on pruritus, skin dryness, and depression in hemodialysis patients.Methods: This was a randomized control group pre-post experimental study. Fifty-four patients undergoing maintenance hemodialysis at a single center voluntarily participated in the study. Twenty-seven participants were randomly assigned to the experimental group, to whom auricular acupressure was applied to five designated acupoints (shenmen, heart, kidney, lung, and occiput) for 5 weeks. The control group (n=27) received no intervention for the first 5 weeks, and the auricular acupressure intervention was administered due to ethical considerations after 5 weeks. Pruritus, pruritus-related sleep disturbance, and depression were scored accordingly. Skin dryness was assessed by measuring transepidermal water loss (TEWL) and stratum corneum hydration (SCH) levels.Results: Auricular acupressure therapy significantly reduced pruritus (z=-3.97, &lt;i&gt;p&lt;/i&gt;&lt;.001) and pruritus-related sleep disturbance (z=-2.97, &lt;i&gt;p&lt;/i&gt;=.003) in the experimental group. TEWL showed a significant reduction in the arm (z=-2.23, &lt;i&gt;p&lt;/i&gt;=.026) and body (z=-1.97, &lt;i&gt;p&lt;/i&gt;=.049) but not in the leg. There were no differences in SCH levels and depression (z=-0.35, &lt;i&gt;p&lt;/i&gt;=.721).Conclusion: Auricular acupressure therapy effectively alleviated pruritus and skin dryness. This study confirmed the safety and effectiveness of auricular acupressure therapy as a viable intervention for pruritus in hemodialysis patients.

The Plasma Neurofilament Light Chain, Brain-Derived Neurotrophic Factor, and Risk of Depression in Chronic Hemodialysis Patients.

Depression is highly prevalent among hemodialysis patients. Understanding the relationship between the plasma neurofilament light chain (NfL) and brain-derived neurotrophic factor (BDNF) may help us to better understand the mechanisms of depression. This study determined their impact, alongside that of other factors, on the risk of depression in hemodialysis patients. The study enrolled 82 patients undergoing chronic hemodialysis. Serum NfL, BDNF, uric acid, urea, potassium, calcium, phosphorus, intact parathyroid hormone, and C-reactive protein (CRP) levels were measured. The patients completed the Beck Depression Inventory (BDI). Blood pressure values, body mass before and after hemodialysis, and weekly duration of hemodialysis in hours were assessed. For 19-month survival analysis, the patients were stratified according to baseline BDI scores. Based on the BDI score, 18.3% of the patients had an increased risk of depression. Lower scores were associated with significantly longer duration of hemodialysis treatment (37.5 (25-57) 24 (14-37) months, p = 0.01). Within the 19-month survival analysis, 31.7% of patients died. The patients with BDI scores above the median had significantly lower survival than those below the median (log-rank test p = 0.02). No significant differences in serum BDNF levels (192.7 [125.2-278.2]; 207.7 [142.8-265.8] pg/mL, p = 0.40), or NfL concentrations (1431.5 [1182.6-1625.7]; 1494.6 [1335.7-1667] kDa, p = 0.52) were found between patients with lower and higher risk of depression. Patients with BDI scores above the median had significantly higher levels of CRP (9.6 [4.4-14]) than those with scores below the median (3.6 [2.2-7.5], p = 0.01). A significant positive correlation was found between the BDI score and serum CRP level (r = 0.38, p = 0.01). A significant negative correlation was observed between the BDI score and URR% value (r = -0.36, p = 0.02). Patients with lower BDI scores had a longer dialysis duration, indicating a potential negative association between depression risk and length of dialysis treatment. Neither serum NfL nor BDNF levels can serve as markers of depression risk in the dialysis population.

Underdiagnosis of Depression in Hemodialysis Patients

Underdiagnosis of Depression in Hemodialysis Patients

Psychotherapies for chronic kidney disease patients with hemodialysis: A systematic review of randomized control trials and quasi-experiments.

Chronic kidney disease (CKD) patients, especially those with hemodialysis, frequently struggle with mental health issues like anxiety and depression. Psychotherapy has been known to treat psychological problems, but its effectiveness in managing CKD patients is still rarely scientifically proven. The aim of this study was to analyze the role of psychological treatments in improving the mental health of CKD patients with hemodialysis. We comprehensively reviewed the related studies published in PubMed, Google Scholar, ScienceDirect, and Clinical Key over the last ten years, up to June 7, 2023. A keyword combination was used in the search engine strategies, and all articles about CKD patients receiving hemodialysis and psychotherapy were included. Based on the eligibility criteria, 716 patients were included in 13 out of 18,830 studies in the final analysis. Psychological problem was complained by 399 CKD patients. The psychotherapy included cognitive behavioral therapy (reported in four studies, n=4), diaphragmatic breathing relaxation (n=1), meditation (n=1), hypnotherapy (n=1), Kidney Optimal Health Program (KOHP) (n=1), psychological intervention (n=1), murottal Al-Qur'an therapy (n=3), and spiritual therapy (n=1). These interventions were performed once to four times a week, for ten minutes to five hours during hemodialysis for two to ten weeks. Meditation and KOHP showed no significant improvement in anxiety and depression. The remaining psychotherapies significantly improved the quality of life by reducing anxiety and depression in hemodialysis patients and enhancing sleep quality, self-esteem, hopefulness, medication adherence, and physical condition. In conclusion, psychotherapy should be considered in an interdisciplinary team to treat CKD patients comprehensively. Further studies are still necessary to determine the efficacy of each psychological intervention in CKD patients with psychiatric problems.

Investigation of Quality of Life and Depression in Hemodialysis Patients and the Relationship Between Them

Çalışmada, hemodiyaliz tedavisi alan hastaların yaşam kalitesi ve depresyon düzeylerini, bunları etkileyen faktörleri belirlemek ve hastaların yaşam kalitesi ve depresyon düzeyleri arasındaki ilişkiyi incelemek amaçlanmıştır. Araştırma, tanımlayıcı ve kesitsel türde bir çalışmadır. Araştırma, Muş Devlet Hastanesi’nde hemodiyaliz tedavisi alan 92 hasta ile gerçekleştirilmiştir. Çalışmada veri toplama araçları olarak Böbrek Hastalığı ve Yaşam Kalitesi Formu ve Beck Depresyon Ölçeği kullanılmıştır. Çalışmada verilerin analizinde betimleyici istatistikler, Mann-Whitney U ve Kruskal Wallis testlerinden ve korelasyon analizinden yararlanılmıştır. Çalışmada hemodiyaliz hastalarının toplam yaşam kalitesi puanı 46.65±10.81; depresyon puan ortalaması ise 14,16±6,08 olarak bulunmuştur. Hastaların orta düzeyin altında yaşam kalitesi puanına sahip oldukları ve hastaların %31,52’sinde depresyon puan ortalamasının Türkiye için belirlenen kesme puanının üzerinde olduğu saptanmıştır. Çalışmada, hemodiyaliz hastalarının cinsiyet, yaş ve eşlik eden hastalık olma durumu özelliklerinin hem yaşam kalitesi ve hem de depresyon düzeyleri üzerinde; medeni durum ve hastalıktan önce çalışma durumu özelliklerinin ise sadece yaşam kalitesi üzerinde istatistiksel olarak anlamlı bir farklılık oluşturduğu tespit edilmiştir. Çalışmada, depresyon ile toplam yaşam kalitesi ve tüm alt boyutları arasında istatistiksel açıdan anlamlı ve negatif yönlü ilişkiler olduğu sonucuna ulaşılmıştır. Gelecekteki araştırmalarda, kronik böbrek yetmezliği hastalığının farklı tedavi yöntemlerinde, hastalardaki depresyonun erken teşhisi ve tedavisinin, hastaların yaşam kalitesini iyileştirmeye yardımcı olup olmayacağı değerlendirilebilir.

Management of Depression in Hemodialysis Patients: a Pilot Study

Management of Depression in Hemodialysis Patients: a Pilot Study

Assessment of Depression in Hemodialysis Patients and Its Impact on Quality of Life

Abstract Background End stage renal disease patients are thought to be highly susceptible to emotional problems. Depression is generally accepted to be the commonest psychological problem in patients with end stage renal disease which will affect the quality of life of these patients. Aim of the Work To assess depression in hemodialysis patients and its impact on physical and mental health. Methods A cross section study was made in Ain shams university hospital and other hemodialysis units on 500 patients on regular Hemodialysis. Results the study show a lower quality of life (both mentally and physically using SF-12 questionnaire) in patients with severe depression compared with those with mild to moderate depression. As quality of life is a predictor of survival in HD patients. Hence, correlation between quality of life and BDI score focuses on the effects of depression on HD patients’ survival. Conclusion Depression is so common among our dialysis patients whatever its degree. Different components of quality of life (physical and mental) are affected among our dialysis patients. Depression score (BDI score) is in direct relationship with age, marital status and employment. Physical, mental and total components of SF12v1 has a significant negative correlation with age, BMI, dialysis vintage and interdialytic weight gain. Associated comorbid diseases had significant correlation with depression and quality of life in our dialysis patients. Depression severity has significant negative correlation with PCS, MCS and the total score of SF12v1. Patients with mild depression have significantly higher scores of the various components of SF12v1 much more than those with moderate depression. Depression is highly statistically significant in predicting of PCS, MCS and the total score of SF12v1 and each increase in depression severity leads to significant decrease in them with different degrees.

Impact of virtual reality exercises on anxiety and depression in hemodialysis

Renal replacement therapy is associated with reduced physical activity. The aim of the study was to assess the relationship between regular physical activity performed with the use of virtual reality and the occurrence of symptoms of anxiety and depression in hemodialysis patients. The study involved 85 patients from the dialysis station at the Department of Nephrology, Transplantology and Internal Medicine PUM. The examined patients were randomly divided into study group and control group. The study group consisted of patients undergoing renal replacement therapy by hemodialysis, whose task was to perform VR exercises using the prototype of the NefroVR system for 20 min during hemodialysis. The control group consisted of patients undergoing renal replacement therapy by hemodialysis who were not assigned an intervention. An intragroup analysis was performed for the Beck and GAD scales. After the end of the exercise cycle in the study group there was a decrease in the score while in the control group there was an increase in comparison to the first result. The research showed that after a 3-month exercises on a bicycle with the use of low-intensity virtual reality, a decrease in depression symptoms measured by the Beck Depression Inventory was observed. The research showed that regular physical activity using virtual reality may be associated with a reduction in the occurrence of anxiety and depression symptoms in patients included in the chronic hemodialysis program.

Association between vascular access type and depression in hemodialysis patients.

Hemodialysis is the most common treatment used for end-stage kidney disease (ESKD) patients and an arteriovenous fistula (AV) fistula is the preferred vascular access. The goal of our study was to investigate potential associations between vascular access type and depression. This was a cross-sectional survey of 180 patients receiving maintenance hemodialysis. The Beck Depression Inventory was used to assess degree of depression. Demographic factors, treatment details, and laboratory values were obtained from the hospital medical record. Fifty-two percent (n = 93) of the patients were being dialyzed using an AV fistula and 48% (n = 87) via a tunneled cuffed catheter. No significant differences were found between access type use in terms of gender (p = 0.266), presence of diabetes, hypertension, or peripheral artery disease (p = 0.409, p = 0.323, p = 0.317; respectively). The prevalence of Beck Depression Inventory scores greater than 14 (marking presence of depression) was significantly higher in the patients being dialyzed with a tunneled cuffed catheters (61%) compared to patients dialyzed with an AV fistula (36%) (p = 0.001). We found statistically higher depression scores among patients receiving hemodialysis with a tunneled cuffed catheter.

The Relationship Between Vascular Access Type and Sleep Quality, Anxiety, Depression in Hemodialysis Patients

The Relationship Between Vascular Access Type and Sleep Quality, Anxiety, Depression in Hemodialysis Patients

Muscle Strength and Biochemical Markers as Predictors of Depression in Hemodialysis Patients: A Cross-Sectional Study.

Patients with chronic renal failure, many of which treated with hemodialysis, present a high prevalence of impaired muscle strength which suggest that muscle mass parameters may be used as markers for changes in muscle in these patients. Measurement of handgrip strength (HGS) is a common, simple, and quick measure of muscle function an indicator of overall muscle strength which has been associated with physical activity and several anthropometric traits. Intercellular adhesion molecule-1 (ICAM-1) and insulin-like growth factor-1 (IGF-1) are biochemical markers associated with inflammatory processes which are a common consequence of dialysis. Additionally, hemodialysis patients frequently present signs of malnutrition and depression. This cross-sectional study aimed to evaluate if muscle and biochemical markers could be used to predict the risk of depression in hemodialysis patients. Several anthropometric parameters, nutrient intake, depression state and the serum levels of ICAM-1 and IGF-1 were determined and Pearson's correlation coefficient and/or Spearman's correlation coefficient were used to test the correlation between them. Our results do not show a correlation between HGF, IGF-1 and ICAM-1 with the depression status of the patients, but mid-arm muscle circumference (MAMC) was statistically and positively correlated with depression. Additionally, ICAM-1 levels were negatively correlated with HGS, MAMC, and IGF-1. Overall, the results of the present study suggest that HGS may be used as an indicator of cardiovascular diseases and MAMC may be a good predictor of the level of depression in hemodialysis patients, although further studies are required.

Frequency and Correlates of Depression in Hemodialysis Patients versus Apparently Healthy Population in Egypt

Background: Depression is the most common mental health condition in the general population. Additionally, depression is common in hemodialysis patients and is associated with a lower quality of life. The social causes of depression have been ignored for a long time. We aimed to assess the severity and correlates of depression in HD patients and compare them to a group of apparently healthy individuals in Egypt. Methods and Subjects: The study was conducted in four dialysis units in Egypt where 234 patients and 242 healthy individuals were recruited. The depression scoring, demographic data, and associated comorbidities were recorded. Depression was measured using the Center for Epidemiologic Studies Depression Scale (CES-D), NIMH. The higher scores indicated the presence of more symptomatology. Results: The total studied groups were 234(136 males, 98 females) patients on dialysis with a mean age of 55.6±13.6 years (range 21–79 years), and 242(157 males, 85 females) healthy individuals with a mean age of 33.6±13.3 years (range 18–70 years). Females both in dialysis patients as well as in the controls had statistically significantly higher depression scores indicating more depressive symptoms, than their male counterparts. Depression scores were significantly negatively correlated with the ages of control individuals, while they had non-significant positive correlations with ages and BMIs in cases. More depressive symptoms were associated with better socioeconomic status and higher education in the control group, although depressive symptoms increased with lower socioeconomic status and lower level of education in HD patients. In HD patients, the severity of depressive symptoms was significantly related to the presence of diabetes mellitus and ischemic heart disease. On the other hand, the more depressive symptoms in HD patients without associated comorbidities were not statistically significantly different from that in the apparently healthy group. Conclusion: The severity of depressive symptoms was different demographically between hemodialysis patients and the apparently healthy individuals, and was more pronounced in patients with more advanced age, lower socioeconomic status, and lower education, necessitating more consideration of social and psychological care for these patients.

혈액투석 환자의 악력, 혈압, 투석적절도, 투석증상 및 우울 간의 관계

Purpose: This study aimed to determine relationships among handgrip strength (HGS), blood pressure, dialysis adequacy, dialysis symptoms, and depression in hemodialysis patients. Methods: Data from 150 subjects were obtained and analyzed, following a descriptive approach. Results: The average grip strength of the subjects was lower than the standard value for both men and women, and the grip strength differed significantly according to age, gender, education level, monthly income, and BMI. The physiological indicators that showed significant results with the study variables were hemoglobin, serum calcium, and serum phosphorus. The average dialysis adequacy (Kt/V) of the subjects was higher than the normal standard, and there were significant differences according to age, gender, education level, monthly income, dialysis period, number of accompanying diseases, and BMI. The subject’s depression score had a significant negative correlation with dialysis adequacy, and the dialysis symptom score and depression score had a significant positive correlation. Conclusion: General characteristics, dialysis-related characteristics, and physiological indicators of hemodialysis patients were analyzed in detail, and differences between these characteristics and grip strength, blood pressure, dialysis adequacy, dialysis symptoms, and depression were also examined. It is necessary to provide delicate nursing according to the individual characteristics of the patient.

Effect of intra-dialytic physical exercise on depression in prevalent hemodialysis patients

BackgroundDepression is associated with morbidity, death, diminished quality of life, decreased longevity, and even suicidal ideation in hemodialysis patients. Intra-dialytic exercise is considered as integral component of the clinical care management of hemodialysis patients as it improves hemodialysis effectiveness, reducing systemic inflammation, increasing exercise tolerance, decreasing depression and improving quality of life. The objective of this study was to assess the effect of intra-dialytic physical exercise on depression and physical activity in prevalent hemodialysis patients. This prospective cohort research comprised 50 hemodialysis patients maintained on regular hemodialysis 3 times/week with duration since starting dialysis (1–5 years), not practicing any previous physical activity, suffering from depressive symptoms, not maintained on antidepressants and separated into two groups: group I underwent intra-dialytic exercise for 3 months and group II was matched in age and gender but did not undertake any exercise.ResultsHamilton depression rating scale was significantly decreased in group I after completing the exercise program compared to baseline (P = 0.000), while there was no significant change in group II. Serum tumor necrosis factor alpha significantly decreased in group I compared to baseline (P = 0.000), while there was no significant change in group II. A positive correlation was found between serum tumor necrosis factor alpha and Hamilton depression rating scale (r = 0.676), (P = 0.000). Physical activity tests; 6-min walk test, rapid assessment of physical activity and peak volume of oxygen consumption were significantly improved in group I compared to baseline (P = 0.000), while there was no statistically significant difference in group II. Serum phosphorus and parathyroid hormone levels were significantly decreased in group I compared to baseline (P < 0.01), while urea reduction ratio was significantly increased in group I compared to baseline (P = 0.000), but there was no significant change in group II.ConclusionsIntra-dialysis exercise can improve depression and physical performance in hemodialysis patients. As positive correlation was found between serum tumor necrosis factor alpha and Hamilton depression rating scale, so tumor necrosis factor alpha may be considered as marker of depression in hemodialysis patients. Intra-dialytic exercise can improve dialysis efficacy by improving urea reduction ratio.

Prevalence of depression in patients with end-stage renal disease undergoing hemodialysis in Saudi Arabia: A cross-sectional study.

A hemodialysis is a treatment option for patients with End-Stage Renal Disease (ESRD). However, patients undergoing hemodialysis three times per week may experience psychological issues, including depression, which are highly prevalent among patients. Unfortunately, most healthcare providers fail to recognize the symptoms of depression due to overlap with other somatic symptoms; thus, depression remains undiagnosed. This study aimed to estimate the prevalence of depression and compare the differences in depression symptoms according to the sociodemographic characteristics of patients with ESRD undergoing hemodialysis. A descriptive, cross-sectional study was conducted from August to October 2021 with a total of 132 hemodialysis patients using the Beck Depression Inventory (BDI II) questionnaire to examine symptoms of depression at multiple health centers in Jeddah. Descriptive statistics, Mann-Whitney U, Kruskal-Wallis, Post-hoc analysis using Conover tests were used for data analysis. The prevalence of depression in hemodialysis patients was 51.5%, 25.8%, 15.9%, and 6.8%, with minimal, mild, moderate, and severe symptoms, respectively. Depression exhibited a significant relationship with sex (p = 0.034), with females showing higher mean depression scores than males. Additionally, depression scores were statistically significant across the different levels of education (p = 0.019), with the mean depression scores significantly highest in subjects who had only primary school level of education. Furthermore, the most common symptoms associated with depression were found to be energy loss and fatigue. Depression prevalence was relatively low among patients with ESRD undergoing hemodialysis, and a loss of energy and fatigue were the most common symptoms correlated with depression. Hence, nurses should be trained on how to routinely use psychological screening scales among patients with ESRD undergoing hemodialysis.

Prevalence of chronic kidney disease-associated pruritus, and association with depression among hemodialysis patients in Khyber Pakhtunkhwa

Chronic kidney disease-associated pruritus (CKD-aP), formerly known as the uremic pruritus, is commonly observed in the patients with the hemodialysis. This study aimed to determine the prevalence of the Ckd-aP and to associate it with depression in hemodialysis patients. A multicenter cross-sectional study was conducted on the patients of CKD-aP Khyber Pakhtunkhwa, from March 2021 to March 2022. This research was conducted at multiple hospitals in the Khyber Pakhtunkhwa (different hospitals such as Hayat Abad Medical Complex, Zia Medical complex, Irfan General Hospital, and others). The sample size for this research was 1000, of which 700 were confirmed patients with the CKD-aP. Research shows that the prevalence of CKD-aP is higher in males than in females. This disease creates a negative impact on mental health and causes a range of depressive disorders, among diseased persons.

MO821: Quality of Life and Depression in Hemodialysis Patients

Abstract BACKGROUND AND AIMS End-stage renal disease (ESRD) has certainly an impact on patients’ health-related quality of life (HRQoL). Depression is, also, highly prevalent in hemodialysis patients. This study aimed to evaluate HRQoL, the prevalence of depression, its associated factors, and its impact on quality of life in our population. METHOD This was a cross-sectional study including 70 hemodialysis patients in Monastir, Tunisia. Depression was evaluated using the Beck Depression Inventory (BDI). Quality of life was assessed with the Short-Form 36. Data were also collected on sociodemographic, laboratory (albumin, parathormone, hemoglobin and phosphorus) and dialysis (dialysis vintage, vascular access and hemodialysis adequacy) characteristics. The analysis was performed with descriptive and analytical statistics. RESULTS Among 70 patients, 64.3% were men. The mean age was 49 ± 15.7 years old. High blood pressure, diabetes and dyslipidemia were the most common comorbidities. Low drug adherence was frequent. The global average score according to the SF-36 was 38.2. The QOL was impaired in 64.2% of the cases. We have identified five variables correlated with impaired QOL: lack of autonomy, a dialysis rhythm of 3 times a week, an age &amp;gt;60 years, low social economic level and living in rural areas. Depression was present in 14.2% of the sample. Depressed patients presented poor quality of life, lower serum albumin and higher parathormone levels. CONCLUSION Our study highlights the high frequency of QOL impairment in patients on hemodialysis. Actions aimed at changing some factors associated with reduced QOL can promote well-being.