Background: People with chronic kidney disease (CKD) undergoing hemodialysis may have symptoms of anxiety and depression that may interfere with adherence to medication treatment. Objectives: to evaluate adherence to medication use and its association with anxiety and depressive symptoms, as well as sociodemographic and clinical characteristics in people with CKD undergoing hemodialysis. Methods: Cross-sectional study, carried out in a hemodialysis center in a city in southwestern Goiás, Goiás, Brazil, involving 105 people with chronic kidney disease undergoing hemodialysis. The ethical aspects were met and data were collected during the months of December 2017 to January 2019, through interviews. For the outcome variables, the Morisky-Green Test and the HAD scale were used for anxiety and depression. Results: The overall prevalence of people adhering to the treatment was 14.3% (95%CI: 7.3-22.9%), with 70.5% having medium and low adherence. Regarding anxiety, the prevalence was 34.3% (95% CI: 25.7 – 42.9), while depression was 35.2% (95% CI: 26.7 – 44.3). There was an association between adherence to drug treatment and poor self-rated health (p=0.001) and anxiety (p=0.039); and marginal significance for depression (p=0.054). There was a weak negative correlation between medication adherence and anxiety (r= -0.275; p=0.005). Gender (p=0.014), self-rated health (p=0.016), and DM (p=0.020) were independently associated with depression. Conclusions: The need for multidimensional care for people on hemodialysis during care is reported, highlighting the low adherence to drug treatment and the presence of anxiety and depression, seeking to improve the quality of life of these people.