Objective. This study aimed to determine serum adropin levels and to examine the relationship of serum adropin levels with nutritional status and lipid profile in patients with kidney failure with replacement therapy (KFRT). Methods. The study consisted of 88 subjects, including 30 patients treated with hemodialysis (HD), 29 patients treated with peritoneal dialysis (PD), and 29 patients who had undergone kidney transplantation (TX). The study included assessing anthropometric measurements, handgrip strength, bioelectrical impedance analysis, malnutrition-inflammation score, dietary intake, resting energy expenditure, and biochemical parameters. The patients’ food consumption was recorded for three days. The malnutrition-inflammation score (MIS) was calculated to assess the patients’ nutritional status. Blood samples were collected for serum adropin and other biochemical parameters. Results. Adropin levels were significantly higher in the TX group when compared to the HD group. Patients with low adropin levels had higher MIS, serum ferritin, and lower low-density lipoprotein-cholesterol (LDL-C) and total cholesterol (total-C) levels. Serum adropin levels were negatively correlated with the MIS and positively correlated with total-C, LDL-C, and HDL-C levels. Multiple linear regression analyses showed that the MIS (β=-0.25 p=0.038) and LDL-C level (β=0.29, p=0.007) were associated with serum adropin. Conclusions. Adropin may be considered as a new marker of nutritional status and possibly plays a role in the pathophysiological mechanisms and complications of patients with KFRT.