Personalized nutrition in haemodialysis: a scoping review of studies published between 2015 and 2025

Background: Protein-energy wasting, chronic inflammation, and functional decline are prevalent among patients undergoing haemodialysis (HD) and are associated with adverse outcomes and reduced quality of life. Although a substantial body of literature exists on nutritional management in HD, evidence has evolved considerably in recent years. Nutritional care in HD remains inconsistent and is limited by restrictive dietary paradigms and organizational barriers. Objective: To map evidence published between 2015 and 2025 on nutritional management in adult patients undergoing HD, focusing on personalized strategies, barriers to effective nutritional care, and patient-centred, function-oriented implementation. Methods: A scoping review was conducted following Joanna Briggs Institute methodology and reported according to PRISMA Extension for Scoping Reviews. PubMed/MEDLINE, Scopus, Web of Science, and Europe PMC were searched for English-language studies published between January 2015 and August 2025. Results: A total of 30 studies were included. The literature describes diverse personalized nutritional approaches, including oral and intradialytic supplementation, plant-forward dietary patterns, microbiota-oriented strategies, and targeted nutrient supplementation. Reported outcomes included nutritional biomarkers, inflammation, body composition, functional measures, and patient-reported experience. Key barriers to effective nutritional care were poor dietary adherence, psychosocial burden, limited health literacy, inconsistent professional guidance, and organizational constraints. Morphofunctional assessment tools provided added value beyond biochemical parameters, and the studies highlighted specific considerations for nutritional risk assessment in older adults undergoing HD. Conclusions: This scoping review highlights a shift towards more personalized and function-oriented nutritional care in HD, while underscoring persistent barriers and substantial evidence heterogeneity. The findings support future research and the development of more integrated, patient-centred, and sustainable nutritional care models.