National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) has provided guidelines for assisting practitioners caring for patients in preparation and during hemodialysis since 1997. The 2015 update of the KDOQI for Hemodialysis Adequacy emphasized topics include high-frequency hemodialysis, prescription flexibility and volume control. Literature reviewed for this update includes clinical trials and observational studies published between 2000 and March 2014.