Abstract Background Pneumonia is common in hemodialysis (HD) patients and has a poor prognosis, but there is little information on an accurate method for evaluating the severity of pneumonia, which is closely associated with prognosis, in HD patients. This study examined a method for evaluating the severity of pneumonia that was closely associated with 30-day mortality in HD patients. Methods This was a retrospective observational study of 64 HD patients. We determined the relationship between the severity of pneumonia using a modified A-DROP (excluding the dehydration section) score and 30-day mortality. Results Nine patients (14.1%) died and 40% of patients with an A-DROP score of 3 or 4 died within 30 days. Logistic regression analysis showed that the A-DROP score was significantly associated with 30-day mortality. The discriminatory ability of the A-DROP score was assessed using area under the receiver operating characteristic curve analysis (0.810; 95% confidence interval 0.653–0.967; p
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