The main purpose of this study is to evaluate the effects of alpha lipoic acid supplementation on serum level of visfatin, markers of oxidative stress, inflammation, and insulin resistance in patients with chronic renal failure undergoing hemodialysis. 60 patients with ESRD who are on hemodialysis for more than 6 months and receive 3 times hemodialysis each week will be included in this study and randomly assigned into the treatment group receiving 600 mg/day of alpha lipoic acid for 8 weeks, or the control group receiving placebo. 24 hrs recalls for 2 days (dialysis and non dialysis day) will be recorded at the baseline and after 8 weeks. Fasting blood samples will be obtained at the baseline and after 8 weeks. Cholesterol, TG, HDL, FBS, and TAC measured by calorimetric method, Visfatin, insulin measured by ELIZA, hsCRP measured by immunoturbidometric method, and MDA measured by flurimetric method in serum will be measured and compared between groups. HOMA-IR will be calculated by formula and LDL by Fridewald formula.