According to the reports of the United States Renal Data System (USRDS), there is a 25% annual mortality rate with nearly 50% of all reported maintenance hemodialysis (HD) patient deaths attributed to atherosclerosis-related complications. Although traditional risk factors of cardiovascular disease (CVD) are common in end-stage renal disease (ESRD) patients, they alone may be insufficient to account for their high prevalence of CVD. Recent evidence demonstrated high plasma homocysteine levels have been established as a risk factor of chronic inflammation and atherosclerosis in patients with ESRD.

Malnutrition and inflammation was associated with poor quality of life, morbidity and mortality. We, the researchers at National Taiwan University Hospital, hope to establish the best predictive profile of HD patient outcome. Thus, we establish several protocols to complete this work.

Inclusion Criteria:

• On HD three times a week for more than 3 months (minimizing the confounding effects of residual renal function)

Exclusion Criteria:

• Malignancy;
• Obvious infections or inflammatory diseases;
• Preexisting haematological disorders; and,
• Clinically significant bleeding, transfusion, hospitalization, surgery, or renal transplantation