Intensive hemodialysis (HD) is an alternate form of renal replacement therapy that augments dialysis frequency, duration, or both. Given that intensive HD provides a closer approximation of normal physiology, enhanced solute removal and improved patient outcomes have been noted in observational and randomized controlled trials (RCTs).1-4 However, recent descriptions of increased infectious complications and conflicting survival outcomes from the extension phases of the FHN (Frequent Hemodialysis Network) trial warrant additional clinical studies to clarify the potential benefits and harm of intensive HD regimens.