Mineshima M, et al. - The clinical significance of Intermittent infusion hemodiafiltration ­(I-HDF) vs hemodialysis (HD) was determined in this multicenter randomized controlled crossover trial. Researchers randomized patients to receive HD, I-HDF, and HD (group A) or I-HDF, HD, and I-HDF (group B) in that series for 14 weeks each. With no changes in session duration or anticoagulant therapy, 4-h treatment sessions were administered to the patients during the study. A GC-110N dialysis machine was used to perform I-HDF. By backfiltration, every 30 min, infusion of 200 ml of ultrapure dialysis fluid at a rate of 150 mL/min was done during the treatment. For ­I-HDF, use of an ABH-P polysulfone membrane hemodiafilter was reported and for HD, use of class 1 or 2 hemodialyzer with a polysulfone membrane not coated with vitamin E and approved by the Japanese reimbursement system was reported. As per outcomes, I-HDF led to significantly lower removal rates of low molecular weight substances and significantly higher removal rates of medium to high molecular weight substances than HD. In addition, significantly less albumin leak was reported during I-HDF than during HD. This suggests that for patients with malnutrition and the elderly in Japan, I-HDF may be an especially suitable dialysis modality.