 Seven hundred and four hemodialysis patients treated in Ege University Hospital Dialysis Unit and eight FMC Clinics will be enrolled into the study 3-year follow-up; percentage of yearly expected end-point 10;expected event-free survival rate for control group during three year is 72.9,a bilateral alpha risk equal to 5; an 90 power to detect an increase of 15 in event-free survival at the end of 3-year follow-up in favor of the each intervention group. Annual drop-out rate is estimated as 15-20. 