Nutritional therapy has a key role in the conservative management of renal disease. This role is even more vital with the advent of advanced renal replacement therapies to support patients with life threatening severe oliguric or anuric acute uremia or the International Renal Interest Society stage IV chronic kidney disease. Nutritional assessment and institution of nutritional support is crucial because dialysis only partially alleviates uremic anorexia. Dialytic patients have a higher risk of protein calorie, iron, zinc, vitamin B6, vitamin C, folic acid, 1,25-dihydroxycholecalciferol, and carnitine malnutritions.