In a study conducted in China in 37 patients on OL-HDF, a decrease in TNF- of 28.1% was observed after a single session of HFR, while IL-6 and CRP concentrations remained unchanged.63 In relation to the inflammatory status of HD patients, the response to treatment of anemia with erythropoietic agents (EAAE) and ferrotherapy has also been explored with HFR, where its effect on hepcidin seems to play a crucial role.73 Although hepcidin has a low PM of 2,8 kD and can be easily removed by conventional HD, some small studies show a greater decrease in hepcidin with HFR as compared with HD, with a decrease in the AAEE requirements.62,74 Beyond its favorable effect on the inflammatory status in HD patients, different studies support the antioxidant capacity of HFR by showing a slight decrease in oxidative stress parameters such as LDL oxidase, superoxide bismutase, catalase, glutathione peroxidase, and hemoperoxidase levels

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Furthermore, it has been reported that lysosomes, peroxisomes, Golgi apparatus, endoplasmic reticulum (ER), and ribosomes are also cleared from the erythroid lineage cells in an autophagy-dependent fashion [32, 36]
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