Objectives: Protein-bound uremic toxins(PBUT) are more likely associated with cardiovascular outcomes in dialysis patients. Post-dilution online hemodialfiltration(Post-OL HDF) and medium cut-off hemodialysis(MCO-HD) are supposed to remove PBUTs efficiently, but there was no study on Asian dialysis patients. Therefore, this study was designed to assess the efficacy to clear PUBTs according to dialysis modalities.  Methods: In this prospective cross over multicenter study, dialysis removal of uremic toxins including urea, lambda free light chain(λ-FLC), beta 2-microglobulin(B2MG), indoxyl sulfate(IS), and p-cresyl sulfate(pCS) was measured in the 22 HD patients on high-flux hemodialysis (HF-HD, FX CorDiax80), Post-OL-HDF (Fx CorDiax800), and MCO-HD (Theranova 500) over three weeks each (Figure 1).  Results: Average convection volume in Post-OL-HDF was 21.44±1.80L. The reduction rate(RR) of middle-molecular weight uremic toxins were significantly higher in MCO-HD and Post-OL-HDF than in HF-HD. The RR of λ-FLC was higher (p=0.001), while the RR of B2MG was lower (p=0.004) in MCO-HD than in Post-OL-HDF. Total albumin removal was highest in MCO-HD (2547.3±968.3mg/session), followed by Post-OL-HDF (778.3±313.2mg/session) and HF-HD (59.9±70.8mg/session). Post dialysis serum levels of IS (HF-HD: 15.8±8.2 mg/L, Post-OL-HDF: 15.1±8.9 mg/L in, MCO-HD: 14.6±9.3 mg/L) and pCS (HF-HD: 26.2±12.8 mg/L, Post-OL-HDF: 26.1±16.4 mg/L, MCO-HD: 23.9±19.9 mg/L) were not statistically different. Total solute removal of IS (HF-HD: 28.7±11.1 mg, Post-OL-HDF: 34.0±13.0 mg, MCO-HD: 33.4±16.4 mg), pCS (HF-HD: 109.8±55.9 mg, Post-OL-HDF: 101.9±69.1mg, MCO-HD: 111.7±67.8 mg), and dialytic clearance of IS (HF-HD: 6.16±1.76 mL/min, Post-OL-HDF: 8.87±6.20 mL/min, MCO-HD: 8.79±3.24 mL/min), pCS (HF-HD: 12.7±2.6 mL/min, Post-OL-HDF: 13.3±7.7 mL/min, MCO-HD: 22.3±22.0 mL/min) also did not show significant difference.  Conclusions: Preliminary analysis identified no significant difference in the removal of PBUTs according to three dialysis modalities, even though albumin removal was highest in MCO-HD. Further ongoing analysis will help to clarify these results.