We have carried out the study of severe acute renal failure demographics, etiology, pathogenesis, treatment results and complications at the Center of Dialysis and Renal Transplant of Clinical Republican Hospital, Chisinau, Moldova. There was analyzed the data of 168 patients with severe acute kidney failure admitted to the Clinical Republican Hospital during the period of 10 years (from 2001 to 2010). The total mortality rate in studied population was 71 (42,26%) patients, being highest in patients with acute renal failure as complication of extrarenal pathology. Main lethal factors included multiorganic failure (28,17%), sepsis and purulent processes (26,76%) and shock of different etiologies (16,90%). 13 (7,74%) patients progressed to end stage renal disease.