The previous studies had shown that selenium, zinc, or L-carnitine supplementation after each HD session for 2-3 months increase the capacity of enzymatic antioxidant protection and the status of malnutrition and decrease the resistance to EPO [36–38] which accentuate the fact that OS development leads to EPO resistance, as we concluded regarding the results of our study. This evidence concerns the gene EPO and malnutrition.