INTRODUCTION: Many dialysis/CKD complications remain unsolved despite standard regimen intensifying by higher flux, larger dialyzers, higher blood flow rate and hemodiafiltation. The most of frequent dialysis studies evaluated five-six times per week regimen. METHODS: The transfer of dialysis unit schedule to seven days per week opens the possibility to increase dialysis frequency per week up to four times for 15% of patients (one additional shift on Sunday). The indications for increased frequency were: uncontrolled hypertension (HT) and hyperphosphatemia (HP), hemodynamic instability (HI) or its combination. RESULTS: Eighteen patients were transfered and have been treating four times per week during >6 months due to baseline HT (6 cases), HP (7), HI (3), or its combination (4). The baseline HD/HDF duration was 52(19÷81) month, age was 54±11 years; spKt/V was 1.49±0.24; 82% of patients had Hb > 10 g/dl – similar to other stable hemodialysis patients in the center (N=98). In three month blood pressure were normalized in 12/12 (100%) of patients with baseline blood pressure >140/90 mmHg; baseline hyperphosphatemia >1.78 (2.15±0.54) resolved in 11/12 (92%); baseline hypotension – in 8/11 (73%) patients. The interdialytic weight gain decreased in 15/16 (94%) patients. No vascular access deterioration occurred despite 33% increase of fistula puncture frequency. No hypokalemia episode was registered (albeit dialysate K+ was 2 mEq/l). None of the patients refused of more frequent regime. The hemoglobin, ferritin and albumin levels were stable. In some patients with substantial phosphate decrease, the total calcium level discordantly increased (remained in target range). Thus, there were no adverse effects of more frequent dialysis during 6-12 months of follow-up. The increased dialysis frequency do not contradict to the current National Clinical Guidelines on Hemodialysis/Hemodiafiltration (dialysis regimen no less than three times per week). CONCLUSIONS: Four times per week regime of hemodialysis is efficient and safe modality for patients with resistant hypertension, hyperphosphatemia, hemodynamic instability.