Einbinder Y, Shnaider A, Ghanayem K, et al. - Because predicting the death risk of patients on hemodialysis (HD) is challenging, and post-HD cell-free DNA (cfDNA) concentration was shown to be predictive of all-cause death in a pilot study, therefore, researchers undertook a larger prospective cohort study at 2 medical centers to corroborate the prognostic power of cfDNA. Via a rapid fluorometric assay on sera collected prior to as well as after 1 HD session, CfDNA levels were determined. A total of 153 patients were observed for 46 months for mortality during which time the death of 47 patients was reported. Evaluating standard blood tests, only post-HD cfDNA concentrations were increased in the non-survivor group vs survivors (959 vs 803 ng/mL). A correlation with age and diabetes was demonstrated by pre- and post-HD cfDNA levels. Lower survival was experienced by patients exhibiting increased cfDNA (> 850 ng/mL) vs those with normal levels. Findings demonstrated the superiority of post-HD cfDNA level over standard blood tests. A role of post-HD cfDNA level was suggested as a biomarker to aid decision-making for HD-treated patients.