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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 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. 2026-01-28T18:54:35Z 2026-01-28T18:54:35Z 2016-05 journal article 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. 0160-564X 10.1111/aor.12704 https://hdl.handle.net/20.500.14352/131224 1525-1594 https://doi.org/10.1111/aor.12704 https://onlinelibrary.wiley.com/doi/10.1111/aor.12704 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/ restricted access Wiley