The results of hemodialysis therapy given in 1988-1994 to 57 patients with acute renal failure at the age of 17-62 years in hemorrhagic fever with renal syndrome (HFRS) are provided. A total of 306 procedures were performed. Hemodialysis was initiated early, before clinical presentation of uremia. The indications for hemodialysis were: oliguria, BUN above 20 mmol/l, serum creatinine level above 0.6 mmol/l. For 11 (19.3%) patients hemodialysis was started because of hyperhydration, for 2 patients (3.5%) it was performed because of hyperkalemia. Infectious complications occurred in 7 (12.3%) patients. One (1.7%) patient died. Hemodialysis induced no complications that could negatively influence the disease. All the patients with severe HFRS need inpatient treatment in hospitals with hemodialysis facilities.