Malnutrition is a common severe problem in dialysis. The prevalence of malnutrition has been estimated as between 30% and 70%. Although malnutrition is not normally listed among the most frequent causes of mortality in these patients, it contributes to cardiovascular mortality through the MIA syndrome (Malnutrition, inflammation and arteriosclerosis) and the severity of infections. The cause of malnutrition in dialysis is frequently due to a multiplicity of factors. The use of the term malnutrition has been criticized when the cause is not scant dietary intake, for practical reasons: if the cause is not a lack of food intake, the treatment will not be an increase in the provision of nutrients. The therapeutic approach to malnutrition in dialysis has recently been reviewed. In this sense, the multifactorial origin requires the problem to be approached from different angles. The case reported is an undernourished dialysis patient in which a chronic gradual deterioration in nutritional status is treated through a multiple therapy approach.