Abstract To evaluate patients’ adherence to hemodialysis (HD) and its relationship to psychosocial variables. Methods: 64 adult patients undergoing HD participated in the study and were assessed in regard to depression, anxiety, social support, disease and treatment knowledge, and adherence. Results: Association between sex and adherence to HD, and to diet and medication was found, as well as between schooling and overall adherence. There is association between disease knowledge and depression, with adherence to fluid restrictions. No association was found between adherence and anxiety. Conclusion: Identifying the determinants of treatment adherence is essential to devise efficacious strategies to improve patients’ quality of life.