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Appetite level evaluated by the appetite and diet assessment tool (ADAT) is associated with several clinical and nutritional variables. Our aim was to expand the study to psychological variables (depression symptoms, anxiety symptoms, and distorted thinking). We studied 96 chronic kidney disease patients treated with hemodialysis three times per week. Representative variables are shown as median (percentile 25–percentile 75) or absolute values. DRI = daily recommended intake. Appetite level Very poor, poor (N=10) Fair, Good (N=31) Very Good (N=55) Tau Sex (F/M) 9 / 1 12 / 19* 22 / 33* -- Age (years) 65 (46–2) 50 (29–65) 47 (33–58)* −0.18& Creatinine (mg/dL) 7.4 (6.9–8.6) 11.1 (8.0–13.9)* 11.3 (9.4–13.0)* Kt/V 1.5 (1.3-1.6) 1.4 (1.2-1.5) 1.4(1.2-1.5) −0.03 Albumin (g/dL) 3.5 (3.3-3.9) 3.6 (3.5-3.8) 3.6 (3.5-3.8) 0.09 DRI (%) 78 (74–88) 88 (80–99)* 101 (99–103)* 0.54& Anxiety score 12 (12–20) 9 (4–16)* 5 (3–10)* –0.26 & ⁎ p < 0.05 versus poor or poor appetite, Mann-Whitney or chi2 test. & p < 0.05, correlation with appetite level (Kendall´s Tau coefficient) Very poor or poor appetite level was associated with female sex, older age, lower creatinine, lower DRI, and higher anxiety symptoms. Intervention of anxiety with cognitive behavioral therapy could improve nutritional treatment among vulnerable patients.