Abstract Background and Aims The role of adipocytokines (ADCK), and particularly of anorectic leptin and of resistin in the mortality of PEW is strongly suspected. Convective techniques (ol-HDF) decrease leptin concentrations but induce a concomitant albumin loss which could be potentially harmful in malnourished patients. The aim of the prospective multicentric randomized study performed in France by the NUTRIPEPA GROUP is to compare one year evolution of 4 ADCK and seric albumin using HDF or HD and membranes with different cut-off. Method 47 patients responding to both criteria of albumin <35 g/l (mean of 3 dosages) and prognostic inflammatory and nutritional index (PINI)≥ 1 were randomized to be treated using either polyester polyarylate (PEPA Nikkiso Japan) or polysufone, polyethersulfone dialyser (control) and followed for one year. Treatment consists in 3*4 hours HD session or in 3 HDF sessions with more than 20 liters reinjection/session. 24 patients were treated with HDF (HDF gr) : 11 with PEPA, 13 with control, and 23 with HD (HD gr) : 13 with PEPA, 10 with control. Oral nutritional supplementation was systematic, eventually completed by intradialytic parenteral nutrition. Albumin, leptin, adiponectin, ghrelin and resistin concentrations were determined at M0, M6, M9, M12. Delta concentration M0-M12 of albumin and of the 4 ADCK were compared with Wilcoxon test. Results At 12 months, decrease of leptin and of resistin was significantly higher in HDF group compare to HD group. There was no significant variation of adiponectin, ghrelin and albumin concentrations regardless of the technic or of dialyser cut-off. Conclusion In PEW, on a one year practice and regardless of the cut-off of the dialyser, HDF decreases both the anorexigenic adipokine leptin and resistin, adipokine implicated in insulin resistance, without harmfull incidence on seric albumin concentration. The decrease of concentrations of leptin and resistin obtained using ol-HDF could explain, at least in part, the reduction of one year mortality that we reported last year in preliminary results of NUTRIPEPA study.