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In summary, it is evident that malnutrition is highly prevalent in ESRD patients. This is clearly related to multiple factors encountered during the pre-dialysis stage, as well as during maintenance dialysis therapy. A body of evidence highlights the existence of relationship between malnutrition and outcome in this patient population. Several preliminary studies suggest that interventions to improve the poor nutritional status of the ESRD patients may actually improve the expected outcome in these patients, although their long-term efficacy is not well established. It is therefore important to emphasize that malnutrition is a major co-morbid condition in the ESRD population and that the nutritional status and the treatment parameters of these patients should be altered to improve not only the mortality outcome of ESRD patients but also their quality of life.