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  1. Sundell, Mary B. RD, LDN, CCRP
  2. Pupim, Lara B. MD
  3. Ikizler, T. Alp MD


Patients with stage 5 chronic kidney disease, also known as end-stage renal disease, must undergo a renal replacement therapy to survive. Hemodialysis is the most commonly used therapy. There have been many advances in this therapy over time; however, morbidity and mortality remain unacceptably high. Many of the known risk factors associated with hemodialysis are nutritionally related; therefore, it is extremely important to have clinically meaningful ways to assess the protein and energy nutritional status of patients undergoing hemodialysis to treat their end-stage renal disease. Although there is no one "gold standard" method to assess nutritional status, there are a number of methods that can be used concurrently for this purpose. This article provides descriptions of the most commonly used and readily available methods, with an emphasis on the tools recommended by the Kidney Disease Outcomes Quality Initiative Clinical Practice Guidelines for Nutrition in Chronic Renal Failure by the National Kidney Foundation