The authors raised various points regarding the use of the Geriatric Nutritional Risk Index (GNRI) to define malnutrition in a study that explored the effects of intradialytic exercise on improving physical function in patients undergoing ambulatory hemodialysis. We are grateful for their insights in defining malnutrition in our protocol and believe that this will assist in clarifying the definition of malnutrition in hemodialysis patients and, hence, support the research community.