Hara T, et al. - In this prospective cohort analysis of 865 hemodialysis (HD) patients, based on the Japanese Dialysis Outcomes and Practice Pattern Study phases 4 and 5, researchers examined the links between intra-dialytic alterations in hemoglobin level and cardiovascular events. The ratio of post-dialysis hemoglobin level to pre-dialysis hemoglobin level (post-Hb/pre-Hb) at baseline was the predictor. Major adverse cardiovascular events (MACEs) were assessed as the primary outcome. Participants were observed over a median duration of 2.6 years, during which, the development of MACEs was documented in 145 (16.8%) patients. A high risk of MACEs was observed in patients undergoing HD in relation to high and low intra-dialytic alterations in hemoglobin concentration.