Cardiovascular diseases (CVDs) are a leading cause of death among hemodialysis (HD) patients. This study investigated the effects of fruits granola (FGR) consumption on blood pressure (BP), serum indoxyl sulfate (IS) levels, and the intestinal microbiome in HD patients. Twenty-four HD patients consumed FGR for two months. Results showed significant decreases in systolic and diastolic BP, estimated salt intake, and serum IS levels. Gut microbiota analysis revealed increased alpha diversity and abundances of *Blautia* and *Neglecta*, along with increased lactic acid- and ethanol-producing bacteria and decreased indole-producing bacteria. FGR consumption may be beneficial for reducing CVD risk factors in HD patients.
