{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:55:03Z","timestamp":1792007703258,"version":"4.4.0"},"reference-count":67,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Hemodiafiltration (HDF) is increasingly used because of its enhanced theoretical clearance of diverse uremic toxins, particularly middle molecules and inflammatory cytokines, relative to conventional hemodialysis (HD), yet evidence on its biochemical benefits remains conflicting. Therefore, this meta-analysis was performed to evaluate the effects of HDF versus HD on uremic toxins, inflammation, anemia, and nutritional parameters. A systematic literature search was conducted using PubMed, Scopus, and the Cochrane Central Register of Controlled Trials to identify relevant studies. Only randomized controlled trials (RCTs) were included. Random-effects meta-analyses were performed to evaluate changes in the prespecified outcomes. Twenty-four RCTs involving 6072 dialysis patients were included. Compared with conventional HD, HDF was associated with significant reductions in serum phosphorus (weighted mean difference [WMD] \u22120.28 mg\/dL; 95% CI \u22120.44 to \u22120.12) and \u03b22-microglobulin (WMD \u22124.84 mg\/dL; 95% CI \u22126.13 to \u22123.54). HDF also significantly reduced serum urea and C-reactive protein (CRP) levels, along with weekly erythropoietin requirements. Serum albumin levels were slightly but significantly lower in the HDF group than in the conventional HD group (WMD \u20130.06 g\/dL; 95% CI \u22120.10 to \u22120.01); however, the clinical significance of such a difference remains uncertain. Higher convective volumes were identified as a key determinant of greater reductions in \u03b22-microglobulin and CRP. Compared with conventional HD, HDF demonstrated superior reductions in several surrogate endpoints, including serum phosphorus, urea, \u03b22-microglobulin, CRP, and weekly erythropoietin requirements. Reduced need for phosphate binders and anemia management may lower treatment-related costs.<\/jats:p>","DOI":"10.3390\/toxins18020086","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T16:32:59Z","timestamp":1770395579000},"page":"86","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effects of Hemodiafiltration Versus Hemodialysis on Uremic Toxins, Inflammatory Markers, Anemia, and Nutritional Parameters: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1765-6159","authenticated-orcid":false,"given":"Wannasit","family":"Wathanavasin","sequence":"first","affiliation":[{"name":"Nephrology Unit, Department of Medicine, Charoenkrung Pracharak Hospital, Bangkok Metropolitan Administration, Bangkok 10120, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1993-1369","authenticated-orcid":false,"given":"Solos","family":"Jaturapisanukul","sequence":"additional","affiliation":[{"name":"Nephrology and Renal Replacement Therapy Division, Department of Internal Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Preeyaporn","family":"Janwetchasil","sequence":"additional","affiliation":[{"name":"Nephrology Unit, Department of Medicine, Charoenkrung Pracharak Hospital, Bangkok Metropolitan Administration, Bangkok 10120, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charat","family":"Thongprayoon","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55901, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9954-9711","authenticated-orcid":false,"given":"Wisit","family":"Cheungpasitporn","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55901, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3346-7040","authenticated-orcid":false,"given":"Tibor","family":"F\u00fcl\u00f6p","sequence":"additional","affiliation":[{"name":"Medicine Service, Ralph H. Johnson VA Medical Center, Charleston, SC 29401, USA"},{"name":"Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC 29425, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1159\/000514550","article-title":"Global Epidemiology of End-Stage Kidney Disease and Disparities in Kidney Replacement Therapy","volume":"52","author":"Thurlow","year":"2021","journal-title":"Am. J. Nephrol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e004251","DOI":"10.1136\/bmjopen-2013-004251","article-title":"Mortality in chronic kidney disease and renal replacement therapy: A population-based cohort study","volume":"4","author":"Neovius","year":"2014","journal-title":"BMJ Open"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S112","DOI":"10.1053\/ajkd.1998.v32.pm9820470","article-title":"Clinical epidemiology of cardiovascular disease in chronic renal disease","volume":"32","author":"Foley","year":"1998","journal-title":"Am. J. Kidney Dis."},{"key":"ref_4","first-page":"196","article-title":"The hemodialysis membranes: A historical perspective, current state and future prospect","volume":"17","author":"Cheung","year":"1997","journal-title":"Semin. Nephrol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Lim, Y.J., Sidor, N.A., Tonial, N.C., Che, A., and Urquhart, B.L. (2021). Uremic Toxins in the Progression of Chronic Kidney Disease and Cardiovascular Disease: Mechanisms and Therapeutic Targets. Toxins, 13.","DOI":"10.3390\/toxins13020142"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.2215\/CJN.02660221","article-title":"Classification of Uremic Toxins and Their Role in Kidney Failure","volume":"16","author":"Rosner","year":"2021","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1111\/j.1525-1594.1978.tb03444.x","article-title":"Hemodiafiltration: A New Alternative To Hemofiltration And Conventional Hemodialysis","volume":"2","author":"Leber","year":"1978","journal-title":"Artif. Organs"},{"key":"ref_8","first-page":"372","article-title":"Kinetics of hemodiafiltration. II. Clinical characterization of a new blood cleansing modality","volume":"85","author":"Henderson","year":"1975","journal-title":"J. Lab. Clin. Med."},{"key":"ref_9","first-page":"e42","article-title":"Effect of Hemodiafiltration or Hemodialysis on Mortality in Kidney Failure","volume":"389","author":"Piccoli","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1681\/ASN.2012080875","article-title":"High-Efficiency Postdilution Online Hemodiafiltration Reduces All-Cause Mortality in Hemodialysis Patients","volume":"24","author":"Maduell","year":"2013","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1093\/ndt\/gfs407","article-title":"Mortality and cardiovascular events in online haemodiafiltration (OL-HDF) compared with high-flux dialysis: Results from the Turkish OL-HDF Study","volume":"28","author":"Ok","year":"2012","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1056\/NEJMoa2304820","article-title":"Effect of Hemodiafiltration or Hemodialysis on Mortality in Kidney Failure","volume":"389","author":"Blankestijn","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1038\/ki.2013.109","article-title":"The ESHOL study: Hemodiafiltration improves survival\u2014But how?","volume":"83","author":"Farrington","year":"2013","journal-title":"Kidney Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1093\/ndt\/gfae003","article-title":"Online haemodiafiltration and all-cause mortality: How fragile are the results of the studies published so far?","volume":"39","author":"Battaglia","year":"2024","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1007\/s11255-016-1364-2","article-title":"Comparison of high-flux hemodialysis with hemodialysis filtration in treatment of uraemic pruritus: A randomized controlled trial","volume":"48","author":"Jiang","year":"2016","journal-title":"Int. Urol. Nephrol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1093\/oxfordjournals.ndt.a027963","article-title":"Online haemodiafiltration versus low-flux haemodialysis. A prospective randomized study","volume":"15","author":"Wizemann","year":"2000","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1159\/000494711","article-title":"Could there be Haemodynamic Stress Effects on Pro-Inflammatory CD14+CD16+ Monocytes during Convective-Diffusive Treatments? A Prospective Randomized Controlled Trial","volume":"47","author":"Bolasco","year":"2019","journal-title":"Blood Purif."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"van Gelder, M.K., Middel, I.R., Vernooij, R.W.M., Bots, M.L., Verhaar, M.C., Masereeuw, R., Grooteman, M.P., Nub\u00e9, M.J., Dorpel, M.A.v.D., and Blankestijn, P.J. (2020). Protein-Bound Uremic Toxins in Hemodialysis Patients Relate to Residual Kidney Function, Are Not Influenced by Convective Transport, and Do Not Relate to Outcome. Toxins, 12.","DOI":"10.3390\/toxins12040234"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-Ospina, D., Mas-Fontao, S., Gracia-Iguacel, C., Avello, A., de Rivera, M.G., Mujika-Marticorena, M., and Gonzalez-Parra, E. (2024). Displacing the Burden: A Review of Protein-Bound Uremic Toxin Clearance Strategies in Chronic Kidney Disease. J. Clin. Med., 13.","DOI":"10.3390\/jcm13051428"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1093\/ndt\/gfs514","article-title":"Effect of ultrapure dialysate on markers of inflammation, oxidative stress, nutrition and anemia parameters: A meta-analysis","volume":"28","author":"Susantitaphong","year":"2013","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2344","DOI":"10.1681\/ASN.V11122344","article-title":"A comparison of on-line hemodiafiltration and high-flux hemodialysis: A prospective clinical study","volume":"11","author":"Schmidt","year":"2000","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1111\/j.1525-1594.2005.29068.x","article-title":"On-line Hemodiafiltration Does Not Induce Inflammatory Response in End-stage Renal Disease Patients: Results From a Multicenter Cross-over Study","volume":"29","author":"Vaslaki","year":"2005","journal-title":"Artif. Organs"},{"key":"ref_23","first-page":"26","article-title":"Prospective randomized cross-over long-term comparison of online haemodiafiltration and ultrapure high-flux haemodialysis","volume":"12","author":"Schiffl","year":"2007","journal-title":"Eur. J. Med. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1053\/j.ajkd.2009.09.023","article-title":"Short-term Effects of Online Hemodiafiltration on Phosphate Control: A Result From the Randomized Controlled Convective Transport Study (CONTRAST)","volume":"55","author":"Penne","year":"2010","journal-title":"Am. J. Kidney Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2617","DOI":"10.1093\/ndt\/gfq761","article-title":"Long-term effects of high-efficiency on-line haemodiafiltration on uraemic toxicity. A multicentre prospective randomized study","volume":"26","author":"Pedrini","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1681\/ASN.2011121140","article-title":"Effect of Online Hemodiafiltration on All-Cause Mortality and Cardiovascular Outcomes","volume":"23","author":"Grooteman","year":"2012","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1159\/000336482","article-title":"Hemodiafiltration Improves Plasma 25-Hepcidin Levels: A Prospective, Randomized, Blinded, Cross-Over Study Comparing Hemodialysis and Hemodiafiltration","volume":"2","author":"Abramson","year":"2012","journal-title":"Nephron Extra"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1007\/s11255-012-0324-8","article-title":"Effects of high-efficiency postdilution online hemodiafiltration and high-flux hemodialysis on serum phosphorus and cardiac structure and function in patients with end-stage renal disease","volume":"45","author":"Francisco","year":"2012","journal-title":"Int. Urol. Nephrol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"216","DOI":"10.3109\/0886022X.2012.743858","article-title":"Can Dialysis Modality Influence Quality of Life in Chronic Hemodialysis Patients? Low-Flux Hemodialysis versus High-Flux Hemodiafiltration: A Cross-Over Study","volume":"35","author":"Kantartzi","year":"2012","journal-title":"Ren. Fail."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1093\/ndt\/gft448","article-title":"High-efficiency on-line haemodiafiltration improves conduit artery endothelial function compared with high-flux haemodialysis in end-stage renal disease patients","volume":"29","author":"Bellien","year":"2013","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1038\/ki.2014.9","article-title":"Online hemodiafiltration reduces systemic inflammation compared to low-flux hemodialysis","volume":"86","author":"Hoedt","year":"2014","journal-title":"Kidney Int."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1159\/000381255","article-title":"A Randomized Trial on Health-Related Patient Satisfaction Level with High-Efficiency Online Hemodiafiltration versus High-Flux Dialysis","volume":"40","author":"Karkar","year":"2015","journal-title":"Blood Purif."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1053\/j.ajkd.2016.10.025","article-title":"A Randomized, Single-Blind, Crossover Trial of Recovery Time in High-Flux Hemodialysis and Hemodiafiltration","volume":"69","author":"Smith","year":"2017","journal-title":"Am. J. Kidney Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.kint.2017.01.013","article-title":"Treatment tolerance and patient-reported outcomes favor online hemodiafiltration compared to high-flux hemodialysis in the elderly","volume":"91","author":"Morena","year":"2017","journal-title":"Kidney Int."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2372","DOI":"10.4049\/jimmunol.1800747","article-title":"Online Hemodiafiltration Inhibits Inflammation-Related Endothelial Dysfunction and Vascular Calcification of Uremic Patients Modulating miR-223 Expression in Plasma Extracellular Vesicles","volume":"202","author":"Cavallari","year":"2019","journal-title":"J. Immunol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1159\/000505572","article-title":"Feasibility of Online Haemodiafiltration in Sleep Apnoea: A Randomized Crossover Study","volume":"49","author":"Chu","year":"2020","journal-title":"Blood Purif."},{"key":"ref_37","first-page":"1057","article-title":"Effect of hemodiafiltration on measured physical activity: Primary results of the HDFIT randomized controlled trial","volume":"36","author":"Larkin","year":"2020","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.2215\/CJN.17151120","article-title":"Effect of Hemodiafiltration on the Progression of Neuropathy with Kidney Failure: A Randomized Controlled Trial","volume":"16","author":"Kang","year":"2021","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1093\/ndt\/gfs530","article-title":"Online haemodiafiltration: Definition, dose quantification and safety revisited","volume":"28","author":"Tattersall","year":"2013","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.2215\/CJN.09471209","article-title":"Variability of Parathyroid Hormone and Other Markers of Bone Mineral Metabolism in Patients Receiving Hemodialysis","volume":"5","author":"Gardham","year":"2010","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"S190","DOI":"10.1046\/j.1523-1755.2001.59780190.x","article-title":"Phosphate removal and hemodialysis conditions","volume":"78","author":"Pohlmeier","year":"2001","journal-title":"Kidney Int Suppl."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1159\/000524512","article-title":"Improving Solute Clearances by Hemodialysis","volume":"51","author":"Lee","year":"2022","journal-title":"Blood Purif."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"9176","DOI":"10.1038\/s41598-025-93443-1","article-title":"Mathematical models for phosphate kinetics in patients on maintenance hemodialysis","volume":"15","author":"Waniewski","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Duval-Sabatier, A., Burtey, S., Pelletier, M., Laforet, M., Dou, L., Sallee, M., Lorec, A.-M., Knidiri, H., Darbon, F., and Berland, Y. (2023). Systematic Comparison of Uremic Toxin Removal Using Different Hemodialysis Modes: A Single-Center Crossover Prospective Observational Study. Biomedicines, 11.","DOI":"10.3390\/biomedicines11020373"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1111\/aor.14161","article-title":"Comparative efficacy between hemodialysis using super high-flux dialyzer with hemoperfusion and high-volume postdilution online hemodiafiltration in removing protein bound and middle molecule uremic toxins: A cross-over randomized controlled trial","volume":"46","author":"Tiranathanagul","year":"2022","journal-title":"Artif. Organs"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1038\/s41581-018-0002-x","article-title":"Haemodialysis membranes","volume":"14","author":"Ronco","year":"2018","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1007\/s40620-017-0422-x","article-title":"Ultrapure dialysis water obtained with additional ultrafilter may reduce inflammation in patients on hemodialysis","volume":"30","author":"Bruzzese","year":"2017","journal-title":"J. Nephrol."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Crespo-Montero, R., G\u00f3mez-L\u00f3pez, V.E., Guerrero-Pav\u00f3n, F., Carmona-Mu\u00f1oz, A., Romero-Salda\u00f1a, M., Ranchal-Sanchez, A., and Aljama-Garc\u00eda, P. (2021). Influence of Tunneled Hemodialysis-Catheters on Inflammation and Mortality in Dialyzed Patients. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18147605"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Wathanavasin, W., Cheungpasitporn, W., Thongprayoon, C., and F\u00fcl\u00f6p, T. (2025). Effects of Dietary Fiber Supplementation on Modulating Uremic Toxins and Inflammation in Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Toxins, 17.","DOI":"10.3390\/toxins17020057"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/j.ajkd.2003.07.016","article-title":"Malnutrition-inflammation complex syndrome in dialysis patients: Causes and consequences","volume":"42","author":"Ikizler","year":"2003","journal-title":"Am. J. Kidney Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2","DOI":"10.2478\/abm-2024-0002","article-title":"Plant-based diets in patients with chronic kidney disease","volume":"18","author":"Wathanavasin","year":"2024","journal-title":"Asian Biomed."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Tashiro, M., Okada, K., Tanaka, Y., Michiwaki, H., Shima, H., Inoue, T., Doi, T., and Minakuchi, J. (2024). Impact of Albumin Leakage on the Mortality of Patients Receiving Hemodialysis or Online Hemodiafiltration. J. Clin. Med., 13.","DOI":"10.3390\/jcm13071865"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s41100-022-00440-5","article-title":"Effects of high albumin leakage on survival between online hemodiafiltration and super high-flux hemodialysis: The HISTORY study","volume":"8","author":"Okada","year":"2022","journal-title":"Ren. Replace. Ther."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"S94","DOI":"10.1046\/j.1523-1755.63.s84.20.x","article-title":"Factors that affect albumin concentration in dialysis patients and their relationship to vascular disease","volume":"63","author":"Kaysen","year":"2003","journal-title":"Kidney Int."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"28090","DOI":"10.1038\/s41598-025-07047-w","article-title":"Improved survival with high albumin leakage in patients with protein-energy wasting and inflammation on hemodialysis and online hemodiafiltration","volume":"15","author":"Okada","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Zhu, Y., Li, J., Lu, H., Shi, Z., and Wang, X. (2024). Effect of hemodiafiltration and hemodialysis on mortality of patients with end-stage kidney disease: A meta-analysis. BMC Nephrol., 25.","DOI":"10.1186\/s12882-024-03810-9"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"100829","DOI":"10.1016\/j.xkme.2024.100829","article-title":"Hemodiafiltration versus Hemodialysis in End-Stage Kidney Disease: A Systematic Review and Meta-Analysis","volume":"6","author":"Tapioca","year":"2024","journal-title":"Kidney Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s41100-025-00606-x","article-title":"Dialysis-related amyloidosis: A review from case series","volume":"11","author":"Ubara","year":"2025","journal-title":"Ren. Replace. Ther."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Pedreros-Rosales, C., Jara, A., Lorca, E., Mezzano, S., Pecoits-Filho, R., and Herrera, P. (2023). Unveiling the Clinical Benefits of High-Volume Hemodiafiltration: Optimizing the Removal of Medium-Weight Uremic Toxins and Beyond. Toxins, 15.","DOI":"10.3390\/toxins15090531"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s40620-023-01771-0","article-title":"Medium cut-off dialyzer for middle molecular uremic toxins in AKI and chronic dialysis","volume":"37","author":"Fiorentino","year":"2024","journal-title":"J. Nephrol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_62","first-page":"14651858","article-title":"Updated guidance for trusted systematic reviews: A new edition of the Cochrane Handbook for Systematic Reviews of Interventions","volume":"10","author":"Cumpston","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1177\/0962280216669183","article-title":"Optimally estimating the sample mean from the sample size, median, mid-range, and\/or mid-quartile range","volume":"27","author":"Luo","year":"2018","journal-title":"Stat. Methods Med. Res."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Wan, X., Wang, W., Liu, J., and Tong, T. (2014). Estimating the sample mean and standard deviation from the sample size, median, range and\/or interquartile range. BMC Med. Res. Methodol., 14.","DOI":"10.1186\/1471-2288-14-135"},{"key":"ref_65","first-page":"1732","article-title":"Meta-analyses involving cross-over trials: Methodological issues","volume":"40","author":"Stedman","year":"2009","journal-title":"Leuk. Res."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"2476736","DOI":"10.1080\/0886022X.2025.2476736","article-title":"Critical appraisal of systematic reviews and meta-analyses: A step-by-step guide for nephrologists","volume":"47","author":"Cheungpasitporn","year":"2025","journal-title":"Ren. Fail."}],"container-title":["Toxins"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6651\/18\/2\/86\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T16:41:27Z","timestamp":1770396087000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6651\/18\/2\/86"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,6]]},"references-count":67,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["toxins18020086"],"URL":"https:\/\/doi.org\/10.3390\/toxins18020086","relation":{},"ISSN":["2072-6651"],"issn-type":[{"value":"2072-6651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,6]]}}}