Approach to hyperkalemia Quiz: Ace Your Exams

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A 65-year-old man presents to his primary care PA to follow up on abnormal laboratory results. He previously had a potassium level of 5.6 mEq/L. His past medical history includes type 2 diabetes mellitus and stage 3 chronic kidney disease. The patient’s laboratory studies are listed below. Which of the following is the most likely cause of the previous hyperkalemia and the current laboratory results?  

Laboratory study
Result
Reference
Potassium
5.7 mEq/L
3.5-5.0 mEq/L
Bicarbonate
22 mEq/L
22-28 mEq/L
Glucose
202 mg/dL
70-110 mg/dL (fasting)
eGFR
35 mL/min/1.73m2
>60mL/min/1.73m2
Creatine kinase
60 units/L
25-90 units/L
Aldosterone
8 ng/dL (supine)
2-5 ng/dL (supine)
Serum osmolality
290 mOsm/kg H2O
275–295 mOsm/kg H2O

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