Shimoda et al.1 recently reported remarkable results using the Green combined score (CS) as a predictive tool for all-cause mortality in maintenance hemodialysis (HD) patients. The CS costs of 4 items such as malnutrition, inactivity, slowness, and weakness and HD patients with CS ≥5 had highest hazard ratio 3.3 (95% confidence interval: 1.59-6.87) for mortality in a 6.5 year interval compared to those with CS