In HD patients, HRQOL may be affected by a number of elements, including clinical manifestations of disease, the treatment side effects, the quality of social activities, nutritional status, hospitalization (9), and some biochemical parameters such as Kt/V, calcium-phosphorus (Ca × P) product (1, 10), parathyroid hormone (PTH) levels (11, 12), anemia (9, 12-14), and serum albumin level (13, 15). This evidence concerns the gene ALB and anemia (phenotype).