An appetite and diet assessment tool (ADAT) was developed for the National Institutes of Health pilot study, Reduction of Morbidity and Mortality in Hemodialysis Patients, to evaluate appetite and factors affecting dietary intake in hemodialysis patients in relation to the dose of dialysis delivered and/or the flux of the dialysis membrane. Forty-seven patients completed the ADAT during baseline (28 men, mean age of 63 years; 19 women, mean age of 61 years), and 31 patients in follow-up (18 men, mean age of 63 years; 13 women, mean age of 60 years). Dietary protein and energy intakes were determined in baseline using diet diary-assisted recalls. The data presented suggest that the ADAT is a practical tool for assessing the relationship between appetite and dietary intake in hemodialysis patients. It may be used in dialysis facilities to evaluate appetite and dietary habits, and to assess the effects of changes in the patient's medical condition that may impact appetite and nutritional status. The effect of delivered dose of dialysis and membrane flux will be assessed during the current full-scale study for possible effects on level of appetite and its correlation with nutritional status, morbidity, and mortality. The full-scale hemodialysis study will provide an opportunity to test the validity and reliability of the ADAT, and its applicability in future clinical trials.