目的　探讨老年急性肾衰 (ARF)与多器官功能衰竭 (MOSE)的临床特点、治疗及转归。方法　 67例 MOSE合并 ARF患者 ,老年组 33例 ,青壮年组 34例 ,对比分析两组患者的病因、临床经过、治疗及转归。结果　老年组由肾实质疾病引起的肾性 ARF占3.0 % ,而青壮年组占 32 .3% ;单纯 ARF老年组病死率 2 5.0 % ,青壮年组 1 1 .1 % ;3个脏器衰竭老年组死亡率 63.6% ,青壮年组 32 .3% ;5个脏器衰竭者均死亡。早期使用 CAVH治疗 ,老年组治疗好转率 39.0 % ,青壮年组 69.0 %。结论　老年组与青壮年组比较由肾实质疾病引起的 ARF明显减少 ,老年组病死率明显高于青壮年组 ,并且随着衰竭器官增多死亡率增高。老年组治愈好转率较青壮年组低 ,治疗中应早期使用 CAVH。 Objective To investigate the clinical features, treatment and prognosis of acute renal failure (ARF) and multiple organ failure (MOSE) in the elderly. Methods Sixty-seven patients with MOSE complicated with ARF, 33 elderly patients and 34 young adults were enrolled in this study. The etiology, clinical course, treatment and prognosis of the two groups were compared. Results Renal ARF was caused by renal parenchymal disease in the elderly group, accounting for 3.0% of the cases in the elderly group, while 32.3% in the young and middle-aged group. The death rate of the ARF elderly group was 5.0%, that of the young adult group was 11.1% In the elderly group, the death rate was 63.6% and in the young and middle-aged group was 32.3%. All five organ failure patients died. Early use of CAVH treatment, the elderly treatment rate of 39.0% improvement, young adults group 69.0%. Conclusions The ARF caused by renal parenchymal disease in the elderly group was significantly lower than that in the young adult group. The mortality in the elderly group was significantly higher than that in the young adult group, and the mortality rate increased with the increase of the failing organs. The improvement rate of cure in the elderly group is lower than that in the young and middle-aged group, and CAVH should be used early in the treatment.