regarding to the evidence from pre-ESRD and CKD patients, earlier studies in patients with heart failure and normal range kidney function have reported a strong correlation between shortening TL and declining kidney function, even after adjustment for age [16, 17]. In this regard, Pim et al, have evaluated association of TL with renal function in 610 patients with heart failure (aged 40 to 80 years), and found that age-and sex-adjusted TL decreased steadily across decreasing quarters of eGFR . Another study by Wong et al, explored the association between TL and renal function in patients with chronic heart failure (n = 866, median age was 74) . They reported that TL was associated with renal function, even after adjustment for age, gender, age at chronic heart failure onset, and severity of chronic heart failure . In contrast, the Heart and Soul study which is longitudinal study of patients with stable coronary heart disease, found that kidney function was not independently associated with shortened TL or telomere shortening over 5 years . However their findings should be considered with caution, considering the focus on relatively old predominantly subjects (mean age was 66.7), with stable coronary heart disease .