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Clinical success with HFR will be determined by the improvement and/or normalization of the clinical-analytical parameters, the benefits in the tolerance of the procedure, in the quality of life and in the morbidity and mortality of the patient previously mentioned.77,78 Drug dose adjustment in Supra-HFR Although there are no specific data in the literature, it is very likely that HFR requires dose adjustment of many drugs, as is the case with other convective and adsorptive techniques.92,93 In critically ill patients, it has bee described high adsorption of piperacillin and vancomycin by coupled plasma filtration adsorption, a type of continuous renal replacement therapy using the same sorbent as HFR with a volume of 140 ml.92 Those drugs within the medium molecular weight range, with low protein binding and neutral or positive charge are those with especially higher clearance during convective techniques compared to conventional HD.93 While waiting for studies analyzing the effect of HFR on antibiotics and other drugs, a practical approach is to administer such drugs after dialysis treatment and perform periodic plasma monitoring.94 Potential barriers to HFR

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J Neurosci 32(17):58215832

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