‘Mortality is proportional to the number of failing organs’ has been the mantra of the intensivist for many years. Medical students soon learn that oliguria not reversed by the administration of fluid is a bad sign. The incidence of acute renal failure (ARF) in the intensive care unit (ICU) can be as high as 40% and in fulfilment of the mantra, many studies have shown that the presence of ARF increases mortality on the ICU.