Up to 80% of patients with chronic kidney disease (CKD) have some degree of mineral and bone disorder (MBD), which is associated with higher morbidity and mortality, specifically from cardiovascular causes. Despite the pharmacological treatment for MBD, its prevalence remains high, especially for patients with kidney failure undergoing chronic hemodialysis (HD) treatment. Restriction of dietary phosphorus along with phosphate binders represents an important part of the treatment of MBD. However, due to this restriction along with a potassium-restricted diet, HD patients limit a variety of foods that contain dietary fiber. The supplementation of dietary fiber, specifically fermentable fiber, has been explored in other clinical populations with MBD, such as female adolescents and postmenopausal women. While it is known that this supplementation leads to a higher production of short-chain fatty acids (SCFA) by the gut microbiota and an effect on the absorption of calcium and magnesium, this mechanism remains unexplored in HD patients. The supplementation of inulin, a fermentable fiber, represents a feasible and low-cost co-adjuvant therapy for the treatment of MBD in HD patients. Therefore, the objective of this dissertation is to examine the effects of the supplementation of inulin on bone and mineral metabolism and the gut microbiota in HD patients