Renal failure Quiz: Ace Your Exams

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A 50-year-old man comes to the office because of generalized weakness for several months. His past medical history includes hypertension and type 1 diabetes mellitus. His renal function has gradually declined over the past three years. Current medications include carvedilol, insulin, and calcitriol. Physical examination demonstrates an ill-appearing male with pale conjunctiva, mucosal pallor and 2+ bilateral lower extremity edema. Glomerular filtration rate assessed 3 months ago was 40 mL/min/1.73 m2 (reference range: 90-120 mL/min/1.73 m2). Hemoglobin is 9 g/dL (13.5-17.5 g/dL). The remainder of the laboratory evaluation is demonstrated below.
 
 Laboratory value  Results  Reference range 
 Serum chemistry  
 Sodium  132 mEq/L  136-146 mEq/L 
 Potassium  4.2 mEq/L  3.5-5 mEq/L 
 Chloride  95 mEq/L  95-105 mEq/L 
 Magnesium  1.7 mEq/L  1.5-2 mEq/L 
 Creatinine  6 mg/dL  0.6-1.2 mg/dL 
 Blood urea nitrogen  70 mg/dL  7-18 mg/dL 
 Serum 25-OH Vitamin D (D2)  45 ng/mL  25-80 ng/mL 
 Serum 1,25-OH Vitamin D (D3)  30 pg/mL  18-64 pg/mL 

Which of the following additional sets of laboratory findings are most likely to be observed in this patient?  

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