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The gut microbiota produces TMAO from substrates mainly found in red meat, eggs, and dairy. However, some saltwater fish also contain high levels of TMAO. Although fish consumption is generally linked to beneficial effects, its effects on CKD patients require further research. Methods and results: This study compares the effect of red meat and cod fish intake on TMAO plasma levels in CKD patients undergoing hemodialysis (HD). Participants received a single animal protein source (red meat vs. cod fish) for lunch and dinner for four consecutive days (each intervention), with a 2\u2010week washout period in between. TMAO plasma levels were analyzed using LC\u2010MS\/MS. All 14 patients concluded the red meat intervention, while one refused to participate in the fish intervention. No significant difference in TMAO plasma levels was found post\u2010red meat (<jats:italic>p<\/jats:italic> = 0.21) or fish intervention (<jats:italic>p<\/jats:italic> = 0.91), as well as between groups (<jats:italic>p<\/jats:italic> = 0.43). Conclusion: In this study, 4 days of red meat and cod fish intake did not significantly impact TMAO levels in HD patients, while other factors may be associated with their circulating levels.<\/jats:p>","DOI":"10.1002\/mnfr.70031","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T08:35:56Z","timestamp":1741854956000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Trimethylamine <i>N<\/i>\u2010Oxide Plasma Levels Following Red Meat and Cod Fish Intake: A Pilot Crossover Trial in Hemodialysis Patients"],"prefix":"10.1002","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3013-091X","authenticated-orcid":false,"given":"Larissa de Mattos","family":"Manh\u00e3es","sequence":"first","affiliation":[{"name":"Graduate Program in Food, Nutrition and Health \u2013 Institute of Nutrition State University of Rio de Janeiro (UERJ)  Rio de Janeiro (RJ) 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