Background: The posttraumatic embitterment disorder (PTED) is a persistent feeling a subgroup of adjustment disorders. Dialysis treatment is may be the trigger event in PTED. However, there are few data for the PTED in in patients with end-stage renal disease (ESRD). In this study, we investigate the clinical characteristics of PTED in patients with chronic kidney disease (CKD) and hemodialysis (HD) patients. Methods: The levels of PTED were assessed using the Korean version of PTED scale in 107 HD patients, 159 CKD patients and 179 patients with estimated glomerular filtration rate (eGFR) >60 ml/min/1.73m2. Patients were divided group with PTED (PTED score >30) and without PTED (PTED score ≤30). Results: The prevalence of PTED was higher in HD patients compared with CKD patients and patients with eGFR>60 ml/min/1.73m2. (24.3%, 5.7% and 6.7%, respectively). Relative risk of PTED in HD patients was 4.47 (95% CI, 2.15-9.30, p<0.001) using patients with eGFR >60 ml/min/1.73m2 as reference category. Increased PTED score significantly associated with decreased quality of life (β= -0.170, p<0.001). Comorbidity assessed by modified Charlson comorbidity index was significant related with for PTED score. Conclusions: Our data show that PTED highly prevalent in HD patients and associated with quality of life. These findings suggest that careful consideration for PTED is needed in HD patients.