This is supported by extensive clinical studies demonstrating that body weight, serum albumin, and even paradoxical risk markers, such as low-normal BP, are among the top factors related to all-cause death in this population.24 Furthermore, interventional trials focused on specific pathophysiologic processes leading to CVD, such as hyperlipidemia and arrhythmia, have not been successful in hemodialysis.25, –27 It may be more useful to consider most deaths among hemodialysis patients in a more complex manner. This evidence concerns the gene ALB and Arrhythmia.