Haemodiafiltration with online regeneration of ultrafiltrate and online HDF are highly biocompatible techniques and no significant difference between HFR and online HDF was observed in terms of reduction of inflammatory markers. Further studies with a longer follow-up are needed to evaluate the clinical relevance of the online endogenous reinfusion to counteract the chronic inflammatory state of the uraemic patient.

Hemodiafiltration with online regeneration of the ultrafiltrate. technique. Different techniques either increase diffusionThe concept of regeneration of dialysis fluids and of ultrafiltrate (high dialyzer surfaces) or convection (high ultrafiltration in particular has been recently revisited. Hemodiafiltration with rates, high infusion volumes). From renal physiology, online regeneration of the ultrafiltrate allows the concomitant urine formation begins with the filtration (convection) of infusion of sodium, calcium, and bicarbonate. Here, we studied essentially protein-free plasma through the glomerular capthe adsorptive characteristics of an integrated two-step sorbent system relative to different solutes present in the ultrafiltrate: illaries. The final urine is quite different from the glomerusodium, calcium, phosphate, bicarbonate, uric acid, creatinine, lar filtrate because, as the fluid flows through the tubule, and ␤ 2 -microglobulin. In vitro studies were performed in order

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Hemodiafiltration (HDF) is well known to increase the solute convective clearance due to increased ultrafiltration but requires substantial amounts of high-quality reinfusion fluid. Initially in the early 90s, individual bags or containers of reinfusion fluid were used and caused many problems related to handling (storage, repeated connections) and costs. Additionally there was an increased risk of circuit contamination. The interest in HDF pushed technological research for online production of sterile and ultrapure reinfusion solutions. Using a 2-chamber filter, it is possible to produce reinfusion fluid from the ultrafiltrate of the patient, which has been 'regenerated' by a sorbent bed, in a closed circuit. This action eliminates any problems of sterility and apyrogenicity, while also providing the possibility of reinfusing physiologically important substances such as bicarbonates and essential and branched-chain amino acids. This HDF method, called hemofiltrate reinfusion (HFR), has been clinically demonstrated to reduce the loss of physiological components and is associated with decreased inflammation and oxidative stress. In addition to its ease of use, the technique is also highly biocompatible. Based on these observations, HFR appears to be a useful technique for patients with complex risk factors such as malnutrition, inflammation and atherosclerosis.