Background
Gastrointestinal (GIT) disturbances are recorded in patients with end stage renal diseases (ESRD) frequently, killed probiotic was reported in to decrease GIT problems many other diseases ; So The aim of our study is to evaluate whether a combination of heat killed probiotic and wheat bran affect the presence and severity of gastrointestinal symptoms (GIS) in hemodialysis children

Patients and methods
Our study was Open label uncontrolled clinical trial conducted on 35 pediatric patients on regular hemodialysis for end stage renal disease. Every patient received one sachet of killed probiotic and wheat bran twice daily for two months. Assessment of GIT symptoms were done one month before administration of the drug, then follow them for two months during intervention then reassess the symptoms.
 
Result
 We found that combined heat killed probiotic +wheat bran administration to hemodialysis children produced significant differences in urea, Hb and Po4 levels compared to baseline levels,  in addition children produced highly significant decrease in all gastrointestinal symptoms (P<0.001)  after 1 month, after 2 months in comparison to baseline. 

Conclusion
We concluded that combination of heat killed probiotic and wheat bran decreases presence and severity of gastrointestinal symptoms (GIS) in hemodialysis children; thus we hypothysed that, our results could represent an important preliminary work that need further justification.