ArticleIn vivo (Athens, Greece)
Efficacy of Supra-HFR in Removing FGF23 and Cytokines: A Single Session Analysis.
Article in In vivo (Athens, Greece). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Revisiting the hemodiafiltration with endogenous reinfusion: what is its merit in clinical practice? A narrative review.Annals of medicine · 2026Review
- Extracorporeal Free-Light-Chain Removal in Myeloma Cast Nephropathy: Plasma Exchange and Hemodialysis Strategies in the Era of Effective Antimyeloma Therapy.Journal of clinical medicine · 2026Review
- Uremic toxins removal and iron status: a medium-term comparison between 4 dialysis techniques (EMPIRE study).Renal failure · 2025Observational
- Hemoadsorption and plasma adsorption: two current options for the 3rd dimension of dialysis purification.Journal of nephrology · 2025Review
- Hemodiafiltration with endogenous reinfusion for uremic toxin removal in patients undergoing maintenance hemodialysis: a pilot study.Renal failure · 2024Article
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
aimSupra hemodiafiltration with reinfusion of the endogenous ultrafiltrate (Supra-HFR) is a dialysis technique used to improve uremic toxin removal in the range of the middle molecular weight molecules. Supra-HFR does not require the preparation and online infusion of high-purity dialysis water because it allows the production of an endogenous ultrafiltrate that undergoes detoxification through an adsorbing resin. PATIENTS AND
methodsWe investigated the ability of Supra-HFR to remove fibroblast growth factor 23 (FGF23), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha), interleukin 8 (IL-8), and transforming growth factor alpha (TGF-alpha) after a single session dialysis in nine patients affected by end stage renal disease (ESRD). The same patients underwent a single session of online hemodiafiltration (OL-HDF) to evaluate possible differences in FGF23 and IL-6 levels.
resultsA significant reduction in FGF23 was observed with both Supra-HFR (p=0.001) and OL-HDF. As for TNF-alpha and TGF-alpha, which were measured using Supra-HFR only, their percentage values were significantly lower at the end of dialysis than at the start (p=0.0028 and p=0.03, respectively). This did not change with post-dialysis rebound. Supra-HFR was found to have no effect on IL-6 and IL-8. Interestingly, the removal rate for FGF23 and IL-6 was similar to that observed with OL-HDF.
conclusionSupra-HFR was not superior to OL-HDF, with suboptimal convective volume in the removal of the molecules tested, especially FGF23, which is considered a large middle molecular weight uremic toxin.
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