A previous pilot test on an online nutrition care algorithm for patients on hemodialysis showed that the algorithm was able to track nutrition changes over time; however, use of the algorithm took time beyond usual care. This study piloted methodology to compare outcomes between patients who received 2 hours with the dietitian each month with or without the algorithm. Data were collected at baseline and 6 months. Outcomes did not differ significantly, although patterns of change in risk factors for serum parathyroid hormone and serum phosphorus varied. The small sample size limits conclusions about outcomes but shows that the methodology is feasible.