The authors were surprised to discover that at Riley Hospital for Children the cost of continuous venovenous hemofiltration (CVVH) constitutes a small fraction of the total admission costs, even when it is performed for a large portion of inpatient stays. A reasonable treatment that gives critically ill children reasonable chances of surviving at reasonable costs, must be considered cost-effective. CVVH currently offers some pediatric patients an additional chance at survival without an extraordinary increase in total hospital bills. Further research regarding patient selection, timing of initiation of therapy, and improving outcomes is recommended.