ALB and autoimmune disease: Of the 208,820 patients, we excluded the following patients: 46,156 patients who did not undergo dialysis for more than 60 consecutive days; 50,627 patients who received treatment modalities other than hemodialysis; 7027 patients who had a history of cancer, autoimmune disease, liver disease, HIV infection, or transplantation; 2368 patients with missing data on serum albumin level, WBC count, and lymphocyte percentage at the first quarter; and 1026 patients whose PNI values were in the >99.5 percentile or <0.5 percentile.