BACKGROUND Continuous renal replacement therapies have become the preferable methods for treating critically ill patients with acute renal failure. We studied the use of continuous venovenous hemodialysis (CVVHD) for the management of multiple organ failure patients with acute renal failure. METHODS Forty patients in intensive care units were studied. Their mean age was 50.5 (range 21 to 82) years. The mean of number of organ system failures per patient was 4.9 (range 4 to 6). All patients required mechanical ventilation. CVVHD was performed from the femoral vein via a double-lumen catheter. Blood flow was maintained via blood pump at rate of 120 to 150 ml/min. Bicarbonate solution was delivered to the dialysate ports of the filter at rate of 700 to 900 ml/hour. Any complications during therapy were recorded. RESULTS The mean urea clearance was 14.7 ml/min and the mean creatinine clearance was 15.4 ml/min. Electrolytes were all within the normal ranges. There were two episodes of extracorporeal circuit blood clotting and one patient experienced hypothermia. Seven of the 40 patients (17.5%) survived. CONCLUSIONS CVVHD is a safe, effective, easily established therapy for managing the multiple organ failure patients with acute renal failure, offering good metabolic, electrolyte, and fluid control.