Prediabetes is a highly prevalent condition, affecting about one-third of adults in the United States Patients with prediabetes have an increased risk for diabetes, with 2% to 10% progressing to diabetes each yea Although prediabetes is frequently considered an intermediary stage in the progression between normoglycemia and diabetes, many individuals may have prediabetes for several years, while some may never progress.

Inclusion Criteria:

• End stage renal disease on dialysis patients aged ≥ 18 years old.

Exclusion Criteria:

1. Patients previously diagnosed with prediabetes.
2. Patients previously diagnosed with diabetes mellitus.
3. Acute Medical Status :Hospitalized patients.
4. Physiological States: Pregnant females.Lactating females.
5. Specific Comorbidities & Conditions: Polycystic kidney disease.
6. New York Heart Association (NYHA) class III or IV heart failure.
7. Known liver cirrhosis. or HIV/AIDS.
8. Renal cancer.
9. Active immunosuppression. or Recent chemotherapy or immunosuppressive therapy.
10. History of organ transplantation.

The study population is defined as adult patients (aged 18 years or older) with End-Stage Renal Disease (ESRD) who are currently on dialysis.

This population will be recruited from a single center: Sohag Faculty of Medicine, Sohag University, Egypt.