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oai:docta.ucm.es:20.500.14352/1312242026-01-29T01:16:30Zcom_20.500.14352_14col_20.500.14352_15

Hemodiafiltration with endogenous reinfusion improved microinflammation and endothelial damage compared with online-hemodiafiltration: a hypothesis generating study Esquivias Motta, Elvira Martín Malo, Alejandro Buendía, Paula Álvarez Lara, María A. Soriano, Sagrario Crespo, Rodolfo Carracedo Añón, Julia María Ramírez, Rafael Aljama, Pedro 616.61 616.12 612 Adsorption Endothelial dysfunction Hemodiafiltration with endogenous reinfusion Inflammation Online-hemodiafiltration Uremic toxins Nefrología y urología Sistema cardiovascular Fisiología 3205.06 Nefrología 2411.03 Fisiología Cardiovascular 3207.04 Patología Cardiovascular Acknowledgments: This work was supported by Plan Nacional Proyectos de Investigación en Salud of Instituto de Salud Carlos III (ISCIII) Fondos Feder Grants (PI10/00960, PI11/01536, PI12/01489, and PI14/00806); Junta de Andalucía Grants (P010-CTS-6337, P11-CTS-7352); Fundación Nefrológica and an unrestricted grant from Bellco S.r.l., Mirandola, Italy. Julia Carracedo was supported by a contract from Fundación de Investigaciones Biomédicas de Córdoba (Servicio Andaluz de Salud, Programa Nicolás Monardes). Hemodiafiltration with endogenous reinfusion (HFR) after ultrafiltrate passage through a resin cartridge combines adsorption, convection, and diffusion. Our prospective single-center crossover study compared HFR and online-hemodiafiltration (OLHDF) effects on two uremic toxins and 13 inflammatory, endothelial status, or oxidative stress markers. After an 8-week run-in period of high-flux hemodialysis, 17 eligible stable dialysis patients (median age 65 years, 10 male) without overt clinical inflammation were scheduled for four 8-week periods in the sequence: HFR/OLHDF/HFR/OLHDF. Relative to OLHDF, HFR was associated with greater indoxyl sulfate removal and lesser abnormalities in all other study variables, namely circulating interleukin-6, tumor necrosis factor-alpha, proportions of activated proinflammatory (CD14+CD16+, CD14++CD16+) monocytes, endothelial progenitor cells, apoptotic endothelial microparticles, vascular endothelial growth factor, vascular cellular adhesion molecule, angiopoietins 2 and 1, annexin V, and superoxide dismutase. Differences were significant (P < 0.05) in median values of 13/15 variables. Study period comparisons were generally consistent with dialysis technique comparisons, as were data from the subgroup completing all study periods (n = 9). Our investigation provides hypothesis-generating results suggesting that compared with OLHDF, HFR improves protein-bound toxin removal, inflammatory and endothelial status, and oxidative stress. European Commission Instituto de Salud Carlos III (España) Junta de Andalucía Fundación Nefrológica de Córdoba Fundación de Investigaciones Biomédicas de Córdoba Bellco Depto. de Genética, Fisiología y Microbiología Fac. de Ciencias Biológicas TRUE pub 2026-01-28T18:54:35Z 2026-01-28T18:54:35Z 2016-05 journal article VoR https://hdl.handle.net/20.500.14352/131224 0160-564X 10.1111/aor.12704 1525-1594 eng info:eu-repo/grantAgreement/MICINN//PI11%2F01536/ES/Senescencia de células endoteliales y generación de microparticulas. Un mecanismo comun en la etiopatogenia de la arteriosclerosis del anciano y el enfermo con insuficiencia renal crónica/ info:eu-repo/grantAgreement/MINECO//PI12%2F01489/ES/Inflamación y enfermedad vascular calcificante en la uremia: Identificación de nuevas dianas diagnósticas y terapéuticas/ info:eu-repo/grantAgreement/MINECO//PI14%2F00806/ES/Papel de microRNAs vehiculados por microparticulas de células senescentes en la enfermedad vascular asociada a la enfermedad renal crónica por nefropatía diabética/ Esquivias-Motta E, Martín-Malo A, Buendia P, Álvarez-Lara MA, Soriano S, Crespo R, Carracedo J, Ramírez R, Aljama P. Hemodiafiltration With Endogenous Reinfusion Improved Microinflammation and Endothelial Damage Compared With Online-Hemodiafiltration: A Hypothesis Generating Study: Thoughts and Progress. Artificial Organs 2017;41:88–98. https://doi.org/10.1111/aor.12704. restricted access application/pdf Wiley