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Background Patients undergoing hemodialysis are prone to psychiatric symptoms due to considerable changes in their individual, social and occupational life which can influence the course and prognosis of renal diseases. Objective The aim of the present study is to evaluate the prevalence of depression, anxiety, and suicidal ideation among patients with chronic kidney disease undergoing hemodialysis in Qazvin, Iran. Methods This descriptive cross- sectional study was performed on 120 patients with chronic kidney disease undergoing hemodialysis in Qazvin, Iran. Prior to study, their demographic and laboratory data were recorded. Dialysis adequacy was assessed using urea reduction ratio (URR) and KT/V formula. Data collection tools were Beck’s Depression Inventory, Beck’s Anxiety Inventory and Beck Scale for Suicidal Ideation. Collected data were analyzed using Pearson correlation test and t-test. Findings The mean level of depression in patients was 13.72 where 79 (65.8%) had depressive symptoms. The severity of symptoms was mild in 47 (39.2%), moderate in 21 (17.5%), and severe in 11 (9.2%). Moreover, the mean level of anxiety was 9.73 where 16 (13.3%) had anxiety symptoms. Of 120 patients, only 8 (6.7%) had suicidal ideation. There was a significant negative association between dialysis adequacy and the severity of depression, anxiety and suicidal ideation. Anxiety symptoms were more frequent among unemployed patients, and the increase in age was associated with the increase in suicidal ideations (P