On the other hand, patients on (HD) may feel anger, despair, fear, changes in self-perception self-confidence, social isolation, loss of autonomy, as well as an ambiguous feeling of fear for life and death, these feelings usually improve with time, also these patients have reversal of roles in the family, loss of employment and feelings of inadequacy. The life of HD patients is characterized by many losses and limitations, the limitation of fluid or food, pain, itching, discomfort, physical activity limitation, weakness, cost of care, feelings of inadequacy and negative moods were identified as the major physiological and psychosocial stressors. Factors such as disposable income, housing and living conditions, as well as safety and the environment can affect positively or negatively the quality of life of individuals