In this study, we found that increased serum protein carbonyl levels were associated with overhydration, sarcopenia, SGA-assessed malnutrition and serum levels of prealbumin, and each standard deviation increase in log-protein carbonyl levels independently predicted all-cause and cardiovascular mortality after adjusting for age, sex, diabetes, CAD, CVD, BMI, dialysis vintage and serum albumin concentration in patients undergoing regular HD. Here, TTR is linked to malnutrition.