A 50-year-old man with polycystic kidney disease arrives at the clinic complaining of constant, severe pain in his shoulders, arms, and legs. Long-standing hypertension treated with ramipril is part of the patient's medical history. The blood pressure is 150/85 mm Hg, and the pulse rate is 78 beats per minute. The cardiopulmonary exam is normal. Large, palpable renal masses are discovered during an abdominal examination. There is some bilateral lower-extremity edema. Two years ago, laboratory results revealed a blood urea nitrogen level of 25 mg/dL and a creatinine level of 2.3 mg/dL. The following are the most recent laboratory results: Which of the following metabolic states is most likely present in this patient?

Question

A 50-year-old man with polycystic kidney disease arrives at the clinic complaining of constant, severe pain in his shoulders, arms, and legs. Long-standing hypertension treated with ramipril is part of the patient's medical history. The blood pressure is 150/85 mm Hg, and the pulse rate is 78 beats per minute. The cardiopulmonary exam is normal. Large, palpable renal masses are discovered during an abdominal examination. There is some bilateral lower-extremity edema. Two years ago, laboratory results revealed a blood urea nitrogen level of 25 mg/dL and a creatinine level of 2.3 mg/dL. The following are the most recent laboratory results:  Which of the following metabolic states is most likely present in this patient?

Quizplus · Accepted Answer

Eductional Objective: Chronic kidney disease disrupts mineralization and bone metabolism, resulting in hyperphosphatemia, secondary hyperparathyroidism, and low calcitriol levels. Patients may be asymptomatic or develop symptoms such as weakness, bone pain, and fractures.

A 50-Year-Old Man with Polycystic Kidney Disease Arrives at the Clinic