INTRODUCTION AND AIMS: Mixed Haemodiafiltration (Mixed HDF), an infusion technique with simultaneous infusion at pre-and post-dilution sites of the hemofilter, has been introduced in the recent years to promote achievement of the highest convective volume (CV) while avoiding the drawbacks of the traditional HDF infusion modes, accounting that high CV and solute removal may substantially improve survival of dialysis patients.Mixed HDF was implemented since 2011 in 21 Centers of the NephroCare Dialysis Network in Italy.Results of its application in terms of uremic toxins removal and survival of a cohort of patients followed for 5 years are presented here.METHODS: 360 patients (101F,259M), aged 64613, range 23-88, on Mixed HDF for at least 6 months in 21 Centers from September 2012 to September 2017 were selected after excluding those with previuos longer vintage in other techniques, which was post-HDF in 69% and high-flux HD in 31%.Lab analyses were extracted from the EuCliD database and averaged by month.Blood flow (QB), CV, Kt/V, treatment time (t) and body weight (BW) were recorded on-line at each session and averaged per month.Kaplan Meier survival analysis was performed as overall data-period and by class of age (1, <54; 2,55-64; 3,65-74; 4, >75y).RESULTS: The mean observation period was 35,6624,9 months, range 6-78.Mean session time was 23967 min, dry BW 73613 kg at the start of follow-up.Trends of QB, CV, markers of small (Kt/V) and middle molecule removal (Beta2-microglobulin level and Reduction Ratio), nutritional and anaemia status throughout the follow-up are reported in Table 1.Four-years Cumulative survival, overall and by AgeClass (Log Rank test 35,6, P<0.001 for age >75y) are shown in Fig. 1,2.Deaths during the 4-year follow up were 34.CONCLUSIONS: Mixed HDF, applied as long-term maintenance dialysis therapy to a large cohort of patients, showed to achieve and maintain high removal rate of uremic toxins of different molecular weights and, actually, a considerable overall survival rate.The high convective volume achievable with this technique (around 40 Liter/session, 62% of which infused in post-dilution) probably contributed to these results, to be confirmed by controlled trials taking into account the limits of the present observational cohort study.