Chronic kidney disease (CKD) occurring concurrently with chronic liver disease (CLD) is a complex medical condition experienced by 5%-55% of patients undergoing hemodialysis,1 whereas 20%-30% of people with CLD are noted to also have CKD.2 The combination of these chronic disease states is associated with increased morbidity and mortality. Patients with either or both conditions, independently and collectively, commonly experience frailty, sarcopenia, and malnutrition.3-5