Theranova Randomized, Controlled, Trial (RCT) in China

Inclusion Criteria: 1. Patients aged ≥18 years old and ≤80 years old, regardless of gender; 2. Patients who are able to sign informed consent form (ICF) after an explanation of the proposed study; 3. Patients who receive in-center HD treatment at a site that routinely implements high flux dialysis and HDF; 4. Patients who have been stable receiving in-center HD/HDF for \>3 months prior to study enrollment; 5. Patients with kidney failure receiving maintained HD treatment with a history of thrice weekly HD, and at least 1 HDF session within 1 month prior to the study shall be judged by the investigator; 6. Patients who have an adequate arteriovenous (AV) fistula or graft, or dual-lumen tunneled catheter capable of providing a blood flow rate (QB) of at least 250 mL/min; 7. Patients have no changes in dialysis prescription (dialyzer, time, dialysis fluid flow rate (QD), QB, sufficient dialysis anticoagulation, and stable prescribed doses) over last 6 treatments as judged by the investigator. The dialysis treatment time should be 3.5 to 4.5 hours per session with minimum QB of 250 mL/min and QD of 500 mL/min; 8. Patients with a minimum total convective volume (including ultrafiltration (UF)) of 16 L post-dilution for the most recent HDF treatment; 9. Patients who have Kt/Vurea \> 1.2 for the last 2 measurements, with the most recent Kt/Vurea measurement taken within 4 weeks before or during study screening. Exclusion Criteria: 1. Patients who have acute kidney injury with the chance for recovery; 2. Pregnant and lactating women; 3. Patients diagnosed with a New York Heart Association (NYHA) Class IV congestive heart failure, or acute coronary syndrome, and/or who have suffered a myocardial infarction within 3 months prior to the start of the study; 4. Patients with known hemodynamic instability, anemia (hemoglobin \<90 g/L), and/or patients with hemoglobin \>130g/L for coagulation risk; 5. Patients with active or ongoing infection as per investigator's judgement (e.g C-reactive protein \[CRP\] level more than 5 folds of normal); 6. Patients who are severely malnourished or with significant disease that interferes with liver synthetic function ( e.g. with serum albumin \<30 g/L); 7. Patients with positive serology tests for Hepatitis B surface antigen, Hepatitis C total antibody, and advanced liver, or pulmonary disease as judged by the investigator; 8. Patients with positive serology tests for human immunodeficiency virus (HIV), Syphilis; 9. Patients receiving immunosuppressive treatment or with autoimmune disease; 10. Patients with a history of solid tumors requiring anti-cancer therapy in the past or next 6 months, or with a life expectancy of \<1 year, or patients with history of hematology neoplasm; 11. Patients who are pre-scheduled for a living donor kidney transplant within the next 1 year, who plan a change to peritoneal dialysis (PD) within the next 1 year, or who require single-needle dialysis therapy; 12. Patients who have had an allergic response to polyarylethersulfone (PAES) or polysulfone (PS) membrane or have history of poor tolerance to dialyzers with synthetic membranes; 13. Patients with a history of severe mental disorders who are unable to provide consent or comply with study procedures as assessed by the investigator; 14. Patients who are currently participating in or have previously participated in other interventional clinical studies during the past 30 days; 15. Patients with any comorbidity possibly conflicting with the study as judged by the investigator.