EPO and major depressive disorder: In local studies, factors associated with depression in hemodialysis patients were found to be male sex,7 marriage,7,8 low income status,7,8 number of children,8 un-employment,8 anemia4 and lower educational level.5,8 In international studies, factors associated with depression in hemodialysis patients were found to be age,13,17 family problems,13 female sex,12,17,18 white race,17,19 poor sleep quality,18 unemploymentduration of dialysis, diabetes,17–19 cardiovascular disease,19 hypoalbuminemia,18 low education,18 pruritus,18 alcohol use12 anduse of erythropoietin.12.