Background: Chronic renal failure is becoming one of the most impacting diseases on the Egyptian population, alongside with cardiovascular and hepatic diseases, diabetes mellitus and cancers. Studies support the importance of dietary management on different aspects related to end-stage renal failure (ESRF) and other studies also suggest that active nutritional counselling can improve certain important biochemical parameters and fluid overload problems in patients on maintenance haemodialysis (HD). Objectives: To assess the effect of dietary counselling on the overall health status of ESRF patients subjected to haemodialysis, particularly their renal functions. Methods: A pretest-posttest study was conducted through several phases; Phase 1: Pre-intervention assessment using; an interview questionnaire to collect socio-demographic, nutritional knowledge and dietary pattern data; Malnutrition Inflammation Score (MIS); Karnofsky Performance Scale (KPS) and anthropometric measurements. Phase 2: Implementation of nutritional counselling sessions communicating evidence-based practices. All patients were given one-to-one nutritional counselling over a six-month period. Phase 3: Post-intervention reassessment of patients using phase one tools. Sampling: A sex-stratified random sample of about 50% of all patients attending El-Harem Centre for Dialysis (82) during the period from October, 1^st 2008 till March, 31^st 2009 were included. Intervention participants totalled 41 ESRF patients. Results: In this study, 97.5 % of patients were considered mildly to moderately malnourished. Multiple malnutrition problems detected among these patients were protein-energy malnutrition, hypocalcaemia, anaemia and hyperphosphataemia. Nutritional counselling sessions resulted in statistically significant changes in the Malnutrition Inflammation Score (MIS) and Karnofsky Performance Scale (KPS) of the patients, the patients' nutrition related knowledge and to some extent their dietary practice. Conclusion: Providing one-to-one nutritional counselling is an effective intervention that can improve the ESRF patients' nutrition related knowledge and practice as well as their compliance to the dietary guidelines for the dialysis patients, which in turn can improve their health status and daily performance.