This study aims to describe the prevalence of malnutrition in pediatric CKD patients and explore nutritional intervention through diet implementation.   A cross-sectional study was conducted in pediatric ward at Dr Cipto Mangunkusumo hospital from January 2018 to December 2019. CKD patients in critical condition were excluded. Patients were classified in age, grade of CKD, nutritional status, malnutrition severity, and prescribed diet therapy. Malnutrition identification was performed using Pediatric Subjective Global Nutrition Assessment (SGNA) method. Energy and nutrient requirements referred to the Kidney Disease Outcomes Quality Initiative (KDOQI) guideline for Nutrition in Children with CKD. There were 94 pediatric patients classified to >5 (92,6%) and <= 5 (6,4%) years old group. Pediatric patients with CKD grade 4-5 took a significant majority (77,7%) followed by grade 1-3 (22,3%). Most patients were considered malnutrition, ranging from moderate (46,8%) to severe (13,8%) degree which specifically more prevalent in CKD grade 4-5 patients with dialysis. Those were closely comparable to patients’ nutrition status. Based on weight-per-height standard and nutrition physical examination, around half of patients were underweight (44%) and became severely wasted (13,8%). Pediatric patients’ had poor appetite and adherence to diet mainly due to anorexia and psychosocial factors such as lack of family support and diet knowledge. Adequate and precise nutrition support enhanced patients’ nutritional status and life quality. It showed that almost half of patients (43,6%) required oral nutrition supplement (calorie-dense renal-specific milk). Furthermore, those with severe conditions had full enteral nutrition through nasogastric tube (11,7%) since they were unable to meet nutritional requirement through solid food or orally alone.   Malnutrition in pediatric CKD patients were highly prevalent that negatively impacted growth, development, and health outcomes. Thus, dietitian had important role to optimize calorie and protein intake by arranging individually-tailored diet plan.through oral, enteral, or combination of both routes.