DISCUSSION DR. BRUCE A. MOLITORIS (Director, Nephrology Division, Professor of
Medicine, and Director, Indiana Center for Biological Microscopy, Indiana University School
of Medicine, Indianapolis, Indiana, USA): This case represents a typical presentation of
multifactorial acute renal failure (ARF). Prerenal azotemia, cocaine-mediated
vasoconstriction and trauma resulted in acute tubular necrosis (ATN) secondary to
rhabodmyolysis and renal hypoperfusion. The pathophysiology and clinical aspects of …