Acute renal failure develops in about two-thirds of patients dying from hepatic failure, l z Renal failure further complicates the metabolic disorder resulting from the primary liver disease and is associated with a poor prognosis. Renal failure was reported to be the primary cause of death in 11% of 471 patients with cirrhosis, z In fulminant hepatic failure the development of renal failure may be disproportionate to the degree of hepatic damage unlike in cirrhosis. ~ Understanding the pathogenesis of renal failure and associated metabolic disturbances in hepatic failure is essential for its possible prevention and management. In this article, the pathophysiology of renal failure and the therapeutic measures are presented. Type of renal failure