Depression and cognitive impairment are the most common complications of patients on hemodialysis. The objective of this study is to identify contributing factors to depression and cognitive impairment in hemodialysis patients. This is a cross-sectional study involving 110 hemodialysis patients in Hospital Kuala Lumpur. The samples were recruited through universal sampling. Patients were assessed with the Beck Depression Inventory and Montreal Cognitive Assessment. This study found that 18.2% of patients had depression, and 48.2% had cognitive impairment. Factors associated with depression were unmarried status, low education level, and cognitive impairment. Factors associated with cognitive impairment were low education level, depression, and unemployment.