It is well documented that malnutrition increases the risk of morbidity and mortality in dialysis patients. At North Iowa Mercy Dialysis Center, a three month baseline study concluded that 46% of the patients were identified at nutritional risk (indicated by albumin less than 3.5 mg/dl). Based on these results, a 15 month multidisciplinary Continuous Quality Improvement (CQI) project to improve nutritional status was implemented. High risk patient groups were identified. These included: (1) Patients living alone; (2) peritoneal dialysis patients; (3) nursing home patients; (4) patients traveling over 30 miles to dialysis. A CQI process improvement plan was developed and implemented. This plan included monthly nutrition education for patients, free dietary supplements, psych/social assessment and intervention, food/ drug interactions, assessment of gastrointestinal medications, etc. Results/Conclusions: CQI methods lead to an overall improvement of nutritional status of patients. The percentage of patients with low albumins improved from 46% to 12%.