Chronic Kidney Disease (CKD) is now clearly recognized as a global public health burden. Although dialysis has become a common practice for patients with end-stage kidney disease in Taiwan, the major objective in CKD management is to delay the progression of CKD. The role of nutritional therapy as a strategy to slow CKD progression has gained much attention recently because of encouraging data in the field of precision medicine, in which disease management should be individualized according to the biologic responses to therapy. In this review, several current approaches to precision nutrition in CKD are illustrated. We also provide novel concepts of precision medicine in nutritional management in CKD that take into account the genetic make-up and gut microbial composition.