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Chronic kidney disease (CKD) is associated with significant metabolic alterations, leading to muscle wasting, frailty, and nutritional deficiencies. Hemodialysis patients are particularly vulnerable to malnutrition due to increased catabolism, dietary restrictions, and systemic inflammation. Sarcopenia, characterized by the loss of muscle mass and function, and frailty, a condition of increased vulnerability to adverse health outcomes, are prevalent in this population and contribute to higher morbidity and mortality. This review explores the nutritional deficiencies commonly observed in haemodialysis patients with sarcopenia and frailty, comparing their dietary intake, biochemical markers, and clinical outcomes. The impact of protein-energy wasting, micronutrient deficiencies, and dietary interventions on muscle health and functional status is examined. Understanding the nutritional challenges in this population is essential for developing targeted dietary and therapeutic strategies to improve patient outcomes and quality of life.