Age

18–65

Sex

ALL

Healthy volunteers

Not accepted

Adult patients with end stage renal disease for more than 3 months on regular hemodialysis (GFR less than 15 ml/min/m2
Receiving stable doses of erythropoietin therapy
Able and willing to provide informed consent

Recent probiotic, antibiotic, or immunosuppressive therapy
Microcytic hypochromic anemia.
Patients with hyperparathyroidism
Recent or planned kidney transplantation Gastrointestinal disorders (active IBD, cancer)
Pregnancy or lactation
Severe comorbidities (e.g., active infection, malignancies)
Cognitive or physical inability to comply with protocol

Probiotics Against Erythropoietin Resistance in Chronic Kidney Disease Patients.