The use of recombinant human erythropoietin (rHuEpo) has revolutionized anemia management of early and late stages of chronic kidney disease. Darbopoietin is also now available for the treatment of anemia of chronic kidney disease. In addition, rHuEpo has been used for the treatment of anemia observed in critical illness. Unfortunately, the existing clinical studies of anemia in critically ill patients do not distinguish between those with and without acute renal failure (ARF). This review summarizes the existing experimental and clinical studies supporting the use of rHuEpo in ARF due to ischemic/nephrotoxic injury and conclusions are drawn on the rationale for further research into the use of this drug in ARF.