The exact mechanism between GDF-15 and hypoalbuminemia remains to be elucidated, but since GDF-15 is related to tumor-induced cachexia and hypoalbuminemia reflects malnutrition in hemodialysis patients [40], there may be a possible link between these two factors to provide more specific information on the nutritional status of ESRD patients. The gene discussed is GDF15; the disease is malnutrition.