Abstract Background Chronic kidney disease is worldwide recognized as a public health problem due to high rates of morbidity and mortality. At the end stage of the disease, which the glomerular filtration rate is equal or less than 15 ml/min/1.73 m², dialysis initiation is usually indicated. In the absence of a consensus on the best time of beginning, the aim of this study was to identify clinical and nutritional factors associated with clinical outcomes with the start of dialysis and death. Methods In a prospective cohort of 82 patients, clinical (underlying renal disease, renal survival time, systolic and diastolic blood pressure, estimated glomerular filtration rate) and nutritional data (protein intake, anthropometry, bioelectrical impedance test, and strength handgrip) were collected. We used mean and standard deviation or median and association of the variables with the outcome entry into dialysis or death, and a Cox regression model was applied. Statistical significance was p < 0.05. Results Fifty-eight patients were included in group 1—G1 (without dialysis)—and 24 patients in group 2—G2 (dialysis). The groups were different in blood urea nitrogen (p = <0.001), serum creatinine (p = 0.003), estimated glomerular filtration rate (p = 0.002), and serum phosphorus (p = 0.002). After multivariate analysis, only serum albumin (HR 0.342, p = 0.004) and glomerular filtration rate (HR 0.001, p = 0.001) were associated with entry into dialysis and death. Conclusions We concluded that lower levels of serum albumin and glomerular filtration rate values are associated with entry into dialysis or death.