Nutritional status should be assessed, and every patient with ESRD should receive a diet plan. ESRD patients on dialysis may spontaneously reduce protein and calorie intake as a result of uremic toxins, elevations in leptin and other cytokines, and delayed gastric emptying.10
The average energy intake of patients with ESRD is lower than the recommended 30 to 35 kcal/kg,11
and 50% of patients reveal evidence of malnutrition.12