The prevalence of chronic kidney disease (CKD) have increased and become one of the major public health concerns
worldwide including Malaysia. Previous studies on CKD generally focused on patients who were already undergoing
dialysis treatment; however, studies investigating the stresses experienced by pre-dialysis CKD patients were limited. This
study aimed to examine the prevalence of psychological distress and their association with the Health Related Quality
of Life (HRQoL) during the different stages of CKD. This cross-sectional study involved 200 pre-dialysis patients from
stages 3 to 5, who were recruited from the Nephrology Clinic at the National University of Malaysia Medical Centre
(UKMMC). The instruments used in this study were the Short Form 36 (measuring HRQoL) and Hospital Anxiety and
Depression Scale (HADS) to measure the psychological distress. The results showed that the prevalence of depression
and anxiety increased proportionally with the CKD stages. The HRQoL sub-component scores declined as the CKD stages
increased except for social functioning. An impaired HRQoL was associated with depression and anxiety in the CKD
patients. The results suggested that it is very important to manage kidney disease at an early stage and that a healthier
lifestyle is adopted.