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PEW can arise from a wide variety of conditions observed in advanced chronic kidney disease or end-stage renal disease (ESRD) [3]. The co-existence of malnutrition and wasting causes these conditions. Dialysis patients often experience wasting conditions because of inflammation, loss of amino acids into the dialysate, acidemia, endocrinological disorders, and anemia. The International Society of Renal Nutrition and Metabolism defines PEW as “a state of decreased body stores of protein and energy fuels (body protein and fat masses)” [6]. Serum albumin is a key factor in PEW, and low serum albumin or reduction in existing albumin level is associated with worse survival, which suggests that preventing PEW is important in improving survival [7].