Oral Versus Intravenous Vitamin B12 Replacement in Hemodialysis Patients

The goal of this clinical trial is to learn whether intravenous (IV) vitamin B12 works better than oral vitamin B12 to correct vitamin B12 deficiency in adults on maintenance hemodialysis. The main questions it aims to answer are: Does IV vitamin B12 raise blood B12 levels more than oral vitamin B12 over four weeks? Does IV vitamin B12 lead to more patients reaching a normal blood B12 level than oral vitamin B12? Do the two routes differ in their effect on blood counts and nerve-related symptoms such as numbness and tingling? Participants will: Receive either an IV injection of vitamin B12 once a week after their dialysis session, or oral vitamin B12 tablets three times a day, for four weeks Have blood tests for vitamin B12 level and blood count at the start of the study and again at week 5 Be checked for nerve-related symptoms such as numbness and tingling at the start of the study and again at week 5 Researchers will compare IV vitamin B12 to oral vitamin B12 to see which route works better at correcting B12 deficiency in hemodialysis patients.