Patients with chronic kidney disease, both predialysis and those on dialysis, are vulnerable to the onslaught if disease which presents in the form of malnutrition and muscle wasting. These two conditions are associated with increased morbidity and mortality which mandates thorough assessment and intervention with the progression of the disease, keeping in mind comorbidities, infection, and intercurrent illness. As no single tool alone can assess the nutritional status of these patients, a systematic approach for the assessment of nutritional status and monitoring dietary prescription with timely follow-up is a prerequisite for mending the quality of life of these patients.

Malnutrition refers to abnormalities induced by an inadequate diet, whereas wasting refers to abnormalities that cannot be corrected solely by increasing the diet.^[6] Although these entities are different in their etiopathogenesis somewhat, both share some common features such as low serum albumin, prealbumin, and body mass index. Although these entities are different in their etiopathogenesis somewhat, both share some common features such as low serum albumin, prealbumin, and body mass index. Hence, subjective and objective assessment of PEW and intervention for correctible factors must be carried out routinely.

Peritoneal dialysis (PD) is a well-accepted form of renal replacement treatment. Glucose is the main agent used as an osmotic agent used in the majority of patients on PD. The other agents used are amino acid and polyglucose solutions in specific circumstances.[ Glucose loading is associated with certain downsides. Increase in plasma glucose leads to increased insulin secretion which leads to increased circulating insulin levels and hyperlipidemia and aggravate atherosclerosis. PD is associated with albumin and amino acid loss on a daily basis, which can be more in highly permeable peritoneal membrane or the presence of peritoneal inflammation.

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited disorder causing chronic kidney disease (CKD) and end-stage renal disease (ESRD). Disease-modifying agents are being developed at a fast pace; however, approved management strategies still need to be improved. including water intake. Low sodium, low protein, and phosphorus diet, remains the cornerstone of the dietary management of these patients.