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Intensive hemodialysis-keeping the faith. In this issue of Kidney International, Tennankore et al. present a robust observational study that evaluates different submodalities of intensive hemodialysis. Their paper addresses a critical question, but more importantly illustrates the limits of statistical adjustment when there is major crossover between groups and important center effect. Intensive hemodialysis remains a strong contender to meet the needs of modern patients, and-no matter how challenging-well-deserving of further definitive study in clinical trials.