The usefulness of hemoperfusion in ESRD therapy has not yet been proven in long-term studies. This negative assessment of results is not meant to impugn the efforts of the many investigators in this field. Their research has led to the development of sorbent cartridges, which have played a major life-saving role in acute poison therapy. Moreover, many futuristic artificial organs, such as the wearable artificial kidney and the prosthetic liver, will be lineal descendants of early sorbent research and their development will be facilitated further by current and future studies. Surely, for all those who are not prematurely discouraged by the negative results to date, hemoperfusion remains a challenging avenue for clinical innovation.