{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T05:30:18Z","timestamp":1786512618314,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hyperphosphatemia is frequent in hemodialysis (HD) patients and associates with cardiovascular mortality. Parameters of online hemodiafiltration (OL\u2010HDF) prescription influencing phosphate removal are poorly understood in real\u2010world clinical settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective observational study including chronic HD patients dialyzed at a single UK university hospital between December 2021 and July 2023. Phosphate removal was quantified from spent dialysate during a midweek session.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Dialysate phosphate was measured during 161 dialysis sessions in 128 unique patients (19 on HD and 109 on OL\u2010HDF), with mean age 63.3\u2009\u00b1\u200916.2\u2009years and 77 (60.1%) men. Mean intra\u2010dialytic phosphate removal was 25.6\u2009\u00b1\u200914.3\u2009mmol per session. In multivariate analysis, pre\u2010HD serum phosphate concentration, session time, and urea distribution volume (\n                      <jats:italic>V<\/jats:italic>\n                      ) were positively associated with intradialytic phosphate removal. A significant interaction between session time and pre\u2010HD serum phosphate concentration indicated that longer sessions provided greater benefit to patients with higher baseline phosphate levels. Conversely, dialysis modality (OL\u2010HDF vs. HD) and substitution volume were not significantly associated with phosphate removal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      OL\u2010HDF and substitution flow do not demonstrate a measurable beneficial impact on phosphate removal in a real\u2010world setting. Session time, pre\u2010HD serum phosphate concentration, and urea distribution volume (\n                      <jats:italic>V<\/jats:italic>\n                      ) are the most relevant determinants of phosphate clearance in real\u2010world clinical practice. Session duration emerges as the most effective modifiable factor for controlling phosphate burden in dialysis patients, particularly for those with higher pre\u2010HD phosphate levels.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.70104","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T11:01:04Z","timestamp":1770030064000},"page":"755-763","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Determinants of Intradialytic Phosphate Removal in Hemodiafiltration From Real\u2010World Clinical Practice"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3841-3049","authenticated-orcid":false,"given":"David A.","family":"Jaques","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension Geneva University Hospitals  Geneva 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