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This study aimed to determine the prevalence of depressive symptoms in hemodialysis patients and peritoneal dialysis patients and to explore the factors that may be related to depressive symptoms among these patients. Material & Methods This was a cross-sectional study of patients with ESRD attending the King Fahad Dialysis Center at King Saud Medical Complex, Riyadh, Saudi Arabia. The study was conducted from mid of October 2013 to end of December 2013. All cases attending the study center throughout the period of the study were included until we reach the required sample size. A total of 266 patients, 133 HD patients and 133 PD patients who at age 18 years or older. Exclusive criteria include illiterate patients; patient who had mental illness would impair their understanding of the Mdm2 questionnaire and patients with a history of depression or on anti-depressives. The study protocol was approved by ethics committee of KSMC and written informed consent was obtained from participants included in the study. The questionnaire consisted of two parts, first part contained socio-demographic data that included gender, age, marital status, educational level, working status, monthly income and duration of dialysis. The second find more part was for evaluation of the depression by using the Zung Self-rating Depression Scale (Zung SDS) which is a widely used and validated. It consists of 20 items that evaluate depressive symptoms, with each question being scored from 1 to 4. Patient were categorized as normal (SDS index, �� standard deviation (SD) for continuous variables. The independent t-test was used for statistical analysis of continuous variables. The chi-square test or Fisher��s exact test were used for the comparison of categorical variables. All analyses were performed using check details the Statistical Package for Social Sciences, windows version 20. A p value