6 diabetic patients with renal failure requiring hemodialysis and/or allograft transplantation developed profound malnutrition as evidenced by weight loss and depressed serum albumin and transferrin levels. Precipitating factors included metabolic gastropathy, sepsis, and/or pancreatitis. The patients underwent total parenteral nutrition (TPN) with an intravenous amino acid, glucose insulin, electrolyte solution as well as lipid emulsion supplements. Body weight and serum total protein and transferrin levels improved significantly. Nitrogen balance studies and electrolyte patterns further suggested improved nutrition. Appetite and activity increased in all patients by the end of intravenous TPN (IVTPN), 4 were fully rehabilitated. IVTPNmay be a useful adjunct in diabetic renal failure with severe malnutrition.