The purpose of this study is to investigate the effects of oral administration of probiotics on the metabolism of uremic toxins, in the patients with End Stage Renal Disease (ESRD). One hundred and fifty hemodialysis patients are recruited, and a Double Blind Randomized Parallel Controlled Trial was performed.The microbiota-derived uremic toxin, such as indoxyl sulfate and p-cresol sulfate, are measured as Primary Outcome. The Fecal microbiome, fecal metabolites, blood metabolites, defecation, Gastrointestinal Symptoms The Kidney Disease Quality of Life and The Occurrence of Cardiovascular Event are also assessed.

Inclusion Criteria:

• Age over 18 years old
• Patients who diagnosed as ESRD with hemodialysis
• Fixed hemodialysis cycle (average 3 times a week)
• Agree to take the products to be studied during the study period, and no longer take other fermented dairy products (live lactic acid bacteria drinks, cheese, yogurt, probiotic products, etc.)
• Agree to sign the informed consent form

Exclusion Criteria:

• Taking antibiotics or antifungal drugs within 30 days before the study
• Have serious allergic reaction to skim milk powder
• Researcher are not sure whether the subjects are willing or able to complete the study
• Subject participated in other research projects within two months before the study