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Abstract
Long-term hemodialysis treatment results in chronic monocyte activation with cytokine release. It generates Treg induction with potential immune dysfunction and associated clinical complications. Recent immunological data and preliminary clinical evidence suggest that synthetic polymers and vitamin E coated membranes are associated with a significant improvement in hemodialysis tolerance when compared to cellulose membranes. The aim of this review is to update cytokine release, T-cell polarization, and its clinical impact in patients under extracorporeal hemodialysis comparing traditional cellulose to synthetic/vitamin E coated membranes.