A 56-year-old man with polycystic kidney disease and chronic renal insufficiency is evaluated for the placement of an arteriovenous fistula for dialysis access. The blood pressure is 140/90 mm Hg, and the pulse rate is 80 beats per minute. The lower extremities have 2+ bilateral edema, according to the examination. The glomerular filtration rate is estimated to be 15 mL/min/1.73 m². Which of the following lab results is most likely in this patient?

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Eductional Objective: Hyperphosphatemia can be caused by chronic kidney disease due to impaired renal phosphorus excretion. When blood phosphate levels rise, fibroblast growth factor 23 is released, which reduces calcitriol production and intestinal calcium absorption. Secondary hyperparathyroidism results from the resulting hypocalcemia and hyperphosphatemia.

A 56-Year-Old Man with Polycystic Kidney Disease and Chronic Renal