The Kidney Disease Outcomes Quality Initiative (K/DOQI) is an evolving, literature-based set of practice guidelines designed to improve measurably the quality of life for dialysis patients. As is characteristic of guidelines, they do not change as rapidly as the literature. The K/DOQI guidelines are not meant as the definitive document and should be not treated as such. Although the guidelines are not perfect, everyone caring for chronic renal patients should be very familiar with the guidelines. It is perfectly acceptable to adopt approaches that differ from the guidelines as long as they are supported by literature. An attempt is made in this article to review the aspects of the guidelines most pertinent to the interventionalist and outline deviations from the guidelines that are supported by literature.