The secondary objectives were to assess changes in nutritional and metabolic parameters, including serum albumin, lipid profile, and dry weight, to evaluate effects on anemia and mineral bone markers, to compare changes in patient-reported outcomes using validated tools (KDQOL-SF and Dialysis Symptom Index) and to assess safety outcomes, including the rate of hospitalizations and all-cause mortality. The gene discussed is ALB; the disease is anemia (phenotype).