Serum 25(OH)D concentrations, which can predict a potential nutritional status not to be evaluated using serum Alb concentrations, should be appropriately assessed and improved in welfare recipients undergoing HD to prevent the long-term adverse consequences of VD deficiency, including frailty and sarcopenia and control medical costs, based on the statement of the Kidney Disease: Improving Global Outcomes guideline for CKD-MBD in 2009 “The potential risks of vitamin D repletion are minimal, and thus, despite uncertain benefit, the Work Group felt that measurement might be beneficial [53].” The gene discussed is ALB; the disease is chronic kidney disease.