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(2022) observed that although a two-month synbiotic intervention consisting of 510 9 CFU Lactobacillus acidophilus and Bifidobacterium longum and 60 mg of FOS in a double-blinded randomized controlled clinical trial involving hemodialysis patients with gastrointestinal complaints had a substantial effect in improving constipation and general quality of life in the synbiotic group, it did not reduce the levels of IS in their serum compared to the placebo group