TY - JOUR T1 - Efficacy of Supra-HFR in Removing FGF23 and Cytokines: A Single Session Analysis JF - In Vivo JO - In Vivo SP - 1769 LP - 1776 DO - 10.21873/invivo.12890 VL - 36 IS - 4 AU - GABRIELE DONATI AU - ANDREA ANGELETTI AU - MARIA CAPPUCCILLI AU - CHIARA DONADEI AU - CHIARA GUGLIELMO AU - ANNA SCRIVO AU - LORENZO GASPERONI AU - MADDALENA ZAMBELLI AU - MARIA MATTIOTTI AU - GAETANO LA MANNA Y1 - 2022/07/01 UR - http://iv.iiarjournals.org/content/36/4/1769.abstract N2 - Background/Aim: Supra 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 Methods: We 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. Results: A 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. Conclusion: Supra-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. ER -