Nocturnal home hemodialysis (NHD) and short daily hemodialysis (SDHD) are novel forms of renal replacement therapies gaining increased attention because of the reversal of many end-stage renal disease (ESRD)-associated pathophysiological perturbations that are not correctable with conventional dialysis. New evidence suggests that such intensive dialysis is associated with improved survival compared with traditional 3-times-a-week hemodialysis and may have a survival advantage comparable to that seen with deceased donor transplantation. If confirmed, these new findings have significant implications for the delivery of care to the ESRD population and warrant further study.