ALB and chronic kidney disease: Oral Nutritional Supplements (ONS) are indicated in CKD patients who do not achieve adequate nutritional intake despite dietary counseling, particularly those meeting one or more of the following objective criteria: unintentional weight loss exceeding 5% within 1–3 months or >10% over 6 months (serum albumin persistently below 3.8 g/dL), dietary energy intake consistently less than 75% of recommended requirements, typically <25 kcal/kg/day, and protein intake below 0.8 g/kg/day in non-dialysis or below 1.2 g/kg/day in dialysis patients.