Eiki K, et al. - In this retrospective analysis, researchers explored the factors influencing the effectiveness of intermittent infusion hemodiafiltration ­(I-HDF) treatment in some patients and ineffectiveness in others and grouped the complex causes related to volume load that were recognized. The volume load (preload) was influenced by bolus dialysate infusion in I-HDF, and both preload and afterload were affected by repeated bolus dialysate infusion in patients with valvular heart disease. Findings revealed the efficacy of I-HDF when brain natriuretic peptide levels, cardiothoracic ratio, and ultrafiltration rate were well controlled and cardiac load was low. In patients who tend to suffer hypotension at the end of a dialysis session, the effectiveness of I-HDF was revealed. The implication of various factors, including different types of load, in inefficiency of I-HDF was shown.