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[The role of high cut off membranes in renal replacement therapy of acute kidney injury in the course of sepsis - the current state of knowledge].

Sepsis as a systemic inflammatory reaction to infection is an important interdisciplinary clinical problem. Over the past 20 years, the number of patients who have contracted sepsis has doubled. The occurrence of acute kidney injury in the course of sepsis increases mortality twice, while chronic kidney disease develops in 50% of the patients who survived sepsis. The pathophysiology of acute kidney injury (AKI) development in the course of sepsis is not fully understood. Some researchers, to emphasize the distinctiveness of AKI in the course of sepsis, describe the changes that occur in the kidneys in its course as sepsis induced-AKI. In the last decade, the theory regarding the possibility of modulation of inflammatory pathways through extracorporeal blood purification methods (HCO - using high cut off membranes) from pro-inflammatory cytokines and attempts to restore homeostasis in this way has gained great recognition. The basis for the implementation of this type of treatment was the "maximum concentration" hypothesis, which assumes that, avoiding the onset of the early peak of circulating proinflammatory molecules is possible to prevent and modulate the clinical effects of an excessively expressed inflammatory reaction in the course of sepsis. This study is an attempt to analyze and summarize the current state of knowledge on the effectiveness of using HCO membranes in patients with sepsis who have developed AKI. For this purpose, the resources of MEDLAIN/Pubmed bases from 1965 to April 2018 have been analyzed, taking into account only the full versions of articles in English, using a combination of the following words: super high-flux, high cut-off, dialysis, renal replacement therapy, filtration, diafiltration, hemodialysis, hemofiltration, hemodiafiltration, sepsis, cytokine, inflammatory mediators, inflammation.