Our laboratory’s main research interest is the nutritional and metabolic aspects of patients with kidney disease with various degrees of renal impairment, i.e. chronic renal insufficiency patients prior to initiation of dialysis, chronic dialysis patients, kidney transplant patients and critically ill patients with acute renal failure. Our studies have focused on three specific areas, namely factors affecting the nutritional and metabolic status of these patients, markers to assess nutritional status, and interventions to prevent and/or treat nutritional and metabolic derangements in kidney disease patients. Our laboratory utilizes sophisticated techniques, i.e. stable isotope kinetic methodology to examine protein and energy balance in these patients. With the use of this methodology, we were able to demonstrate the adverse metabolic effects of hemodialysis procedure, including its protein and energy catabolic effects and the activation of inflammatory cascade. We subsequently showed the acute anabolic effects of intradialytic parenteral and oral nutritional supplementation along with the additive anabolic effects of exercise on these interventions, both on skeletal muscle protein balance and albumin synthesis. Another area of our laboratory’s interest is dialytic and nutritional management of acute renal failure patients consistent with the general theme of nutrition and metabolism in kidney disease. Our work on this patient population is focused on detailed assessment of body composition and nutritional status, quantification of level of dialytic support, the metabolic effects of nutritional supplementation. Finally, we are interested in the management of vascular access in dialysis patients, i.e. studies in assessment and early detection of malfunctioning grafts and fistulas.