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This review provides a general introduction to dietary noncompliance in patients with chronic renal failure treated with hemodialysis; an evaluation of the current status of assessment and intervention; and suggestions for the development of treatment design strategies. The first section presents an overview of hemodialysis. The second includes a review of the literature related to compliance to specific hemodialysis regimens. Based on the strengths and weaknesses of current research, the third section focuses specifically on knowledge of effective interventions used to treat noncompliance to hemodialysis dietary regimens. The fourth section highlights implications for the development of treatment design strategies for increasing compliance.