We aimed to test whether there are sex differences in circulating biomarkers in patients with ESKD, and whether there are sex-specific differences in GDF-15, YKL-40, MMP-9 levels in relationship to: (1) gut microbiota (by TMAO); (2) coronary artery calcification (by CAC score), and arteriosclerosis (by scoring of medial calcification in epigastric arteries); (3) inflammation (by hsCRP, TNF and IL-6); (4) oxidative stress (by 8-hydroxy-2ʹ-deoxyguanosine; 8-OHdG), and (5) comorbidities and all-cause mortality. The gene discussed is CHI3L1; the disease is arteriosclerosis.