The question of the optimal mean arterial pressure to optimise renal perfusion and renal function is still unresolved. Redfors et al. [6] approached this question in an elegant crossover study including 12 postcardiac surgery patients with norepinephrine-dependent vasodilatory shock. Increasing the target mean arterial pressure (MAP) from 60 to 75 mmHg resulted in significantly improved GFR (27%) and urinary output associated with increased oxygen delivery (13%) and reduced renal oxygen consumption. A further increase of MAP to 90 mmHg was ineffective or even detrimental for these parameters. The results indicate severely disturbed autoregulation of the kidney in vasodilatory shock and possible benefits from targeting a higher MAP of around 75 mmHg.