ALB and nutritional deficiency disease: The present concept paper suggests employing a stepwise approach against malnutrition in dialysis, starting from nutritional counseling, trying to increase the intake of healthy food, exploiting the potential of intradialytic snacks, followed by nutritional supplements, choosing between different combination, favoring snacks rich in energy or in proteins, upgrading to intradialytic intravenous nutrition, and leaving albumin infusion as a last resort in patients who are metabolically non-reactive and severely malnourished patients.