EPO and Iron deficiency anemia: In chronic kidney disease, fructose can elevate protein levels in urine by impacting the glomerular filtration rate, and in long-term chronic kidney disease, it may result in complications such as anemia due to reduced erythropoietin production by the kidneys (70, 71), iron deficiency in the body due to reduced red blood cell viability (72, 73), and a mineral bone disease caused by disorders of vitamin D, calcium, and phosphate metabolism (74).