The HEMO study has provided evidence that a higher dialysis dose per session does not improve survival in conventional three times a week hemodialysis (HD). Attention has therefore shifted to HD schedules that vary in frequency and/or duration of dialysis. Although observational data favoring the use of frequent dialysis are steadily accumulating, compelling evidence supporting its superiority is still lacking. Several advances have recently been made with a view to put this form of therapy on much more solid footing. Upcoming research initiatives including clinical trials of frequent HD and the quotidian HD registry will provide a wealth of analytic and descriptive data that will help define the role for frequent HD regimens as a therapy for end-stage renal disease.