## 2 Results
### Effects of Symbiotic on IS and PCS Plasma Levels  
There was no statistically significant difference, at baseline, between the symbiotic (A) and placebo (B) group for both plasma IS (\(p\) = 0.36) and PCS levels (\(p\) = 0.25). Although not statistically significant,  
\begin{table}
\begin{tabular}{c c c c c c} \hline \hline  & \multicolumn{3}{c}{**Study Population**} & \multicolumn{3}{c}{**Controls**} \\ \cline{2-6}
**Patients Data** & **Baseline (T0)** & **BHD** & **DVB-PVP HD** & **Baseline** & **BHD** & **DVB-PVP HD** \\  & **Baseline (T7w)** & **(T8w)** & **(T0)** & **(T7w)** & **(T8w)** \\ \cline{2-6}  & **Patients treated with Symbiotic (\(u\) = 6)** & **Patients treated with Placebo (\(u\) = 5)** \\ \hline Age, years & \multicolumn{3}{c}{\(56\times 7\)} & \multicolumn{3}{c}{\(52\pm 5\)} \\ Male, n(\%) & \multicolumn{3}{c}{\(5\)(83\%)} & \multicolumn{3}{c}{\(4\)(05\%)} \\ SCr, mg/dL & \(8.5\pm 1.2\) & \(8.1\pm 1.5\) & \(8.4\pm 1.1\) & \(9.4\pm 1.5\) & \(8.5\pm 2.4\) & \(7.5\pm 2.7\)\% \\ Albumin, g/dL & \(3.6\pm 0.4\) & \(3.7\pm 0.2\) & \(3.3\pm 0.4\)* & \(3.4\pm 0.4\) & \(3.3\pm 0.4\) & \(3.0\pm 0.3\)* \\ Azorella mg/dL & \(132\pm 44\) & \(125\pm 20\) & \(114\pm 19\) & \(120\pm 33\) & \(114\pm 42\) & \(100\pm 54\) \\ Glycemia, mg/dL & \(51\pm 19\) & \(48\pm 30\) & \(79\pm 16\)* & \(72\pm 12\) & \(80\pm 20\) & \(84\pm 23\) \\ CPR mg/L & \(6.4\pm 5.1\) & \(3.1\pm 0.4\) & \(5.8\pm 3.9\) & \(10\pm 14\) & \(10\pm 9\) & \(10\pm 7\) \\ \hline \end{tabular}
\end{table}
Table 2: Demographic, clinical, and biochemical data of hemodialysis patients at baseline (T0) and at each time point: after 7 weeks of treatment with symbiotic or placebo (T7w), and after the eighth week of treatment with symbiotic or placebo combined with innovative dialysis (T8w). BHD: Bicarbonate Hemodialysis; DVB-PVP HD: DVB-PVP-cartridge hemodialysis; sCr: serum creatinine; CRP: C-reactive protein. * \(p\) < 0,05 DVB HD vs. BHD; \(p\) < 0.05 DVB HD vs. Baseline ([PERSON] signed rank test).  
Figure 3: Study Design.  
the seven-weeks symbiotic treatment showed a reduction trend in pre- and post-dialysis levels (ug/mL) of total IS (19.9 \(\pm\) 7, T7w-pre; 9.9 \(\pm\) 5, T7w-post) and PCS (28.9 \(\pm\) 9, T7w-pre; 17.2 \(\pm\) 5, T7w-post) compared to baseline (20.5 \(\pm\) 8, T0-pre and 12,6 \(\pm\) 8, T0-post for IS; 33.7 \(\pm\) 18, T0-pre and 21.7 \(\pm\) 9, T0-post for PCS) (Figure 4A), while in the control group the placebo administration did not (Figure 4B).  
Figure 4: Plasma concentrations of the total IS and PCS in the two groups (**A** Synbiotic and **B** Placebo) of dialysis patients: (**A**) at baseline (T0-pre/post-dialysis); after 7 weeks of symbiotic treatment (T7w-pre/post-dialysis); mean values before and after the three dialysis sessions with the DVB-cartridge with the symbiotic treatment at week 8 (T8w-pre/post-dialysis). At the top right of each chart, the values before and after each dialog session carried out at week 8 are reported: first (1-pre/post), second (2- pre/post), and third (3-pre/post) dialysis session. (**B**) at baseline (T0-pre/post-dialysis); after 7 weeks of placebo treatment (T7w-pre/post-dialysis); mean values before and after the three dialysis sessions with DVB-cartridge with the placebo treatment at week 8 (T8w-pre/post-dialysis). At the top right of each chart, the values before and after each dialog session carried out at week 8 are reported: first (1-pre/post), second (2-pre/post), and third (3-pre/post) dialysis session. Data are expressed as mean \(\pm\) SE. (Wilcoxon test).