The impact of haemofiltration on the systemic cardiovascular response

Convective transport across the dialysis membrane has long been known to be a good alternative to diffusion. Among the advantages of haemofiltration o ver conventional haemodialysis is a better cardiovascular stability. Haemof iltration has a more physiological response to fluid removal than haemodial ysis: (i) blood volume may be better preserved, especially in patients with a compromised cardiac function; (ii) arterial peripheral resistances and v enous tone increase; and (iii) myocardial contractility is neither depresse d nor altered. We discuss the role of the different pathophysiological mech anisms in the disparity in cardiovascular reactivity between haemofiltratio n and haemodialysis.