Raja SM, et al. - By performing this descriptive cross-sectional study, researchers focused on unveiling the patterns of intradialytic complications exclusively in patients with end stage renal disease undergoing twice-weekly hemodialysis at Dialysis Unit of Orotta National Referral Hospital, Asmara, Eritrea. Overall 29 patients were analyzed, including 19 (65.5%) males and 10 (34.5%) females. One or more intradialytic complication in 176 (30.7%) of overall 573 hemodialysis sessions was reported. The most frequent complication happening in 10% of the sessions was hypotension, followed by nausea and vomiting (5.24%), hypertension (5.06%), muscle cramps (4.71%), and headache (4.54%). Higher complication rate was observed in relation to the use of central line catheter as a vascular access. According to the findings, the intradialytic complications in twice-weekly hemodialysis vs the “standard” thrice-weekly frequency was probably similar in patients with end stage renal disease. Although twice-weekly hemodialysis schedule was definitely unsuitable for some patients, it did afford the benefit of preserving residual kidney function which could avert excessive interdialytic weight gain and therefore reducing the risk of intradialytic hypotension associated with higher ultrafiltration rate.