Background & aims: Uraemic symptoms as a result of reduced kidney function may impact on an individual's functional and nutritional status. This study aims to investigate whether providing individualised nutritional counselling can improve nutritional status and influence quality of life in pre-dialysis chronic kidney disease patients. Methods: Fifty-three stage IV and V pre-dialysis chronic kidney disease patients underwent assessment of nutritional status (by Patient Generated Subjective Global Assessment) and quality of life (by Kidney Disease Quality of Life™). Participants were assessed at baseline and following a 12-week randomised-controlled treatment, allocated to either individualised counselling with regular follow-up (n = 24) or standard care treatment (generic education only (n = 23)). Results: At baseline, nutritional status was significantly correlated with all general quality of life sub-scales. There was a statistically significant mean difference in change between groups for: symptoms of kidney disease (7.1 (0.1-14.1) p = 0.047); cognitive functioning (14.6 (5.4-23.7) p = 0.003); and vitality (12.0 (4.6-19.5) p = 0.002) favouring intervention treatment. Conclusions: Quality of life is related to nutritional status in pre-dialysis patients. Providing individualised nutritional counselling improves many components of quality of life, compared with standard nutrition care, in the stage prior to dialysis treatment.