The adequacy of hemodialysis can be evaluated by several indicators: 1. Time-averaged urea concentration, which can be calculated by the area under the urea nitrogen time curve, reflects the balance between urea production and clearance, when this indicator is less than 50 mg/dL, it represents the adequacy of dialysis. 2. Urea decline rate, which reflects the fraction of urea clearance during a single dialysis session, when this indicator is greater than 65%, it represents the adequacy of dialysis. 3. Regardless of the criteria used to assess the adequacy of dialysis, the adequacy of dialysis must also be closely integrated with clinical practice, and the patient’s dry weight, hematological parameters, blood pressure, cardiovascular complications, nutritional status and calcium and phosphorus metabolism should be evaluated regularly. The dialysis dose should be readily adjusted according to the primary etiology and changes in the condition.