crushing injury. Myoglobin is an iron-containing pigment in skeletal muscle. When this muscle is damaged, myoglobin is released into the bloodstream, which is then filtered out by the kidneys. Myoglobin breaks down into potentially toxic compounds which may harm the kidneys. Acute renal failure may also result from direct injury to the kidney, infections, and kidney stones which result from high concentrations of urine in the kidneys, which allows substances in the urine to crystallize and form stones. Other causes include blood disorders, such as idiopathic thrombocytopenic purpura (ITP) which results from the lymph tissues producing antibodies against platelets causing bleeding and lowering the blood pressure. (Janssen, 1996)
             Acute renal failure is commonly a predecessor to end-stage renal failure (ESRF) which occurs "when the glomerular [blood] filtration rate (GFR) approaches 5 mL/min" (Mallick, 1999, p.737). This means that the kidneys are operating at under 10% of their potential. (Baillod, 1995) During ESRF patients lose body mass and retain phosphate, salt, and water. Production of calcitriol, which is active in the regulation of the absorption of calcium in the gastrointestinal tract, is disturbed, leading to faster deterioration of bones. Also, there is a deterioration in the "production of vasodilator compounds such as nitric oxide and kinins" (Mallick, 1999, p.737). Vasodilator compounds allow blood vessels to dilate and allow more, smoother blood flow.
             The best method for renal replacement is to get a kidney replaced, but since the demand and supply of healthy kidneys is so unbalanced (4 to 1) that most people would die before receiving their donor kidney. Treatments for ESRF are expensive, complex, and long-term, usually for the rest of the patients life. The treatment must remove all unwanted toxins and harmful compounds while restoring needed nutrients and hormones which are no longer...