Blood samples were taken in a nonfasting state before a midweek hemodialysis session. Complete blood count, creatinine, urea, albumin, transferrin, total carbon dioxide, hsCRP , triglycerides (TG), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and fasting blood glucose are measured by routine laboratory methods. Another blood samples will be stored at -80 degree centigrade for subsequent assay of items such as insulin, interleukin-6, pentraxin, nitrotyrosine for markers of endothelial dysfunction such as Asymmetric dimethylarginine( ADMA), adropin and insulin resistance (adiponectin, resistin and leptin). Homeostatic Model Assessment Insulin Resistance(HOMA-IR) was calculated as fasting insulin (U/l) × fasting glucose (mg/dl)/405, as described by Matthews et al.