In this study, patients who underwent stable hemodialysis at least 3 months at Tung Taichung Metroharbor Hospital will be enrolled. Baseline clinical data such as age, sex, height, bodyweight , clinical etiology of Chronic kidney disease(CKD) if possible, comorbidities, blood pressure, laboratory measures [such as serum creatinine, albumin, C-reactive protein (CRP), total cholesterol, complete blood counts, urine routines, anthropometric information and various potential indicators of protein energy wasting [such as body mass index, waist/hip ratio, mid-arm circumference (MAC), triceps skinfold thickness (TSF), mid-arm muscle circumference (MAMC), mid-arm muscle area (MAMA), SGA, BIS analyses, dual energy x-ray absorptiometry(DEXA),handgrip (HG)] will be collected. For the laboratory tests, fasting blood and urine samples are obtained from each patient and performed by means of routine methods in the investigators hospital. All patients received echocardiograms studies performed within 3 months after enrollment, which were used to estimate congestive heart failure(CHF, defined as an ejection fraction of <50%) or left ventricular hypertrophy (LVH, defined as left ventricle mass index >125 g/m2 in men and 100 g/m2 in women).Cardiovascular disease( CVD) was defined as a previous history of CHF, LVH, ischemic heart disease(including prior history of angina, myocardial infarction, coronary artery bypass grafting and percutaneous cardiac catheter intervention) or cerebrovascular disease (including prior history of transient ischemic attack and stroke). Information about conventional clinical risk factors, such as smoking, diabetes mellitus, hypertension, medication and other necessary data at baseline will be obtained from a standardized interview and examination. The diagnosis of type 2 diabetes is made according to the criteria of the American Diabetes Association.