Inclusion Criteria:  Patients with hemodialysis Community-dwellers Able to walk with or without assistive devices for more than 100 meters  Exclusion Criteria:  A person with cancer disease. People with psychiatric symptoms. A person who has an absorption disorder or has a history of resection of the small intestine or colon Pregnant women A person treated for acute bacterial infections A person who is in a wheelchair due to inconvenience in walking.