This document discusses a case of acute renal failure in a 28-year-old intravenous drug user who presented with a sore and swollen arm. He was found to have rhabdomyolysis, elevated creatinine and urea levels, as well as an anterior septal myocardial infarction. Further examination revealed he was hepatitis C positive. His renal impairment was likely due to cardiovascular collapse, vessel problems from cocaine use, or rhabdomyolysis. He was difficult to manage and discharged for behavioral issues, with improving but still abnormal renal function and liver tests.