Microbiota and Protein-energy Wasting (MIDIWA)

Inclusion Criteria: * Age ≥ 18 years. * Maintenance hemodialysis for at least 3 months. * Fasting predialysis plasma albumin \< 38 g/l in the absence of any known acute infection during the last 2 weeks or body weight loss \> 5% of estimated dry body weight over 3 months * Dietary intakes (24h dietary recall) between 20-30 kcal/kg/d and \< 1 g protein/kg/d on one occasion, during screening. These intakes will not include the intake of oral nutritional supplements, as intakes below 20 kcal/kg/d request artificial nutrition * Absence of any systematic antibiotic treatment for an acute infection in the month preceding the inclusion Exclusion Criteria: * Known psychiatric or cognitive disorder, precluding protocol compliance. * Life expectancy below 1 year. * Inadequate dialysis (Kt/V\<1.2 on 3 consecutive occasions, for HD patients only), if applicable. * Enteral or parenteral nutrition. * Drugs or oral nutritional supplements containing fibers since ≤ 1 month. * Known reasons for decreased plasma albumin levels as liver failure or exudative enteropathy. * Drugs influencing body composition, ≤ 1 month : systemic corticosteroids, anabolic drugs as insulin or testosterone, post-menopausal hormone therapy, injectable contraceptives. * Known endocrinological disorders potentially leading to hypo- or hypermetabolism, untreated or treated since ≤ 1 month : disorders of thyroid gland, adrenal glands... * Pregnancy and breast-feeding.