Material and Methods: This descriptive-analytic study was conducted on 58 eligible, randomly selected patients of 165 hemodialysis patients referred to Panje Azar Hospital in Gorgan. The instruments were a demographic checklist, Fatigue Severity Scale, Beck Anxiety Inventory, and the Beck Depression Inventory. The data was analyzed by SPSS 17 software using Mann-Whitney, Kruskal-Wallis, Spearman's correlation coefficient and linear regression. 

Results: The mean average of fatigue in all patients was 1.66±4.76. Twenty-six of the participants (44.8%) expressed that they suffer from moderate anxiety, 17 (29.3%) from severe depression and 43 (74.1%) from poor quality of sleep. The relationship between fatigue and anxiety (P = 0.006, r = 0.353) and depression (P≤.001, r=0.525) was directly significant whereas the relationship is not significant for sleep quality. 

Conclusion: Given the high prevalence of fatigue in hemodialysis patients and the impact of multiple factors, we strongly recommend that care providers should consider these factors to improve patients’ quality of life.