Nocturnal hemodialysis in the home has emerged as a very impressive modality when managing patients with end-stage renal failure. The added dialysis time, combined with gentle solute and water removal has led to the improvement in several important parameters in patients who undergo it. However, not all patients can manage the complexities or some of the practicalities of having dialysis in the home. In this month's issue of Clinical Journal of the ASN, Dr. Goldstein et al report on their experience with nocturnal dialysis in hospital. Several parameters were positively effected by this novel therapy where patients sleep three nights per week at St. Michael's Hospital in Toronto. The study suggests that this modality is a viable option when caring for patients with end-stage renal failure.