Kim JK, Lee HW, Joo N, et al. - Given that dysregulation of innate immunity has been suggested as a crucial contributing factor for advanced atherosclerosis and resultant high mortality in hemodialysis (HD) patients, researchers assessed in vivo neutrophil extracellular traps (NETs) for their long-term prognostic role. In 281 incident HD patients, measurements were obtained for circulating serum nucleosome, myeloperoxidase (MPO), and deoxyribonuclease (DNase) I levels. HD patients vs controls had significantly higher circulating nucleosome level. Also, a close link of circulating nucleosome level with MPO levels was observed, indicating increased in vivo NETs in uremia. Significantly increased all-cause and adverse cardiovascular (CV) death was observed in patients in the nucleosome Q4 group vs those in the Q1–3 group even after adjusting conventional risk factors. HD patients vs controls had significantly higher serum DNase I level, which displayed no correlation with NETs. It has utility as an additive biomarker for foretelling poor CV outcomes. An importance independent prognostic significance in incident HD patients might be offered by two new biomarkers.