EGF, IGF-I, and HGF are involved in the endogenous tissue repair after acute renal injury. All three growth factors accelerate the recovery of renal function and the anatomical restoration of tubular integrity when given exogenously to laboratory animals with experimental ARF. However, clinical study of the therapeutic efficacy of recombinant peptide growth factors in ARF is limited to rhIGF-I. Both clinical trials of rhIGF-I in patients with ARF have been indeterminant or negative. Thus, the therapeutic use of peptide growth factors may not be the magic bullet for the cure of a disease that contributes significantly to morbidity and mortality in severely ill patients. However, there is ample experimental basis for further clinical study of recombinant human peptide growth factors in ARF.