Abstract
Hemofiltration is a very popular renal replacement modality related to a supposed improved hemodynamic tolerance. If some animal studies found positive haemodynamic effects including myocardial performance improvement, human studies especially in the setting of acute renal failure or severe sepsis failed to demonstrate any convincing conclusion. Moreover, the analysis of inflammatory biomarkers of sepsis (cytokines, complement...) did not allow to better understand the supposed mechanism of haemodynamic improvement due to this renal replacement therapy. It seems that more efficient modalities of middle molecules removal, such as high volume hemofiltration may induce a greater clinical effect. These preliminary studies are hopeful in the era of blood purification in sepsis, even if mechanisms are still poorly understood.
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