A 66-year-old woman comes to the physician for a follow-up dialysis appointment. She has long-standing diabetes mellitus and dyslipidemia. Vitals are: temperature 98.6 F, HR 72, RR 16, BP 130/80. Medications are insulin, enalapril, and atorvastatin. Laboratory studies show:
Creatinine 4.4 mg/dL
BUN 70 mg/dL
Na+ 140 mEq/L
K+ 6.1 mEq/L
Ca2+ 7.5 mg/dL
Which of the following is most likely to be seen in this patient?
A) Decreased 24,25-vitamin D3
B) Diminution of renin-angiotensin-aldosterone system function
C) Increased fecal cation
D) Increased kaliuresis
E) Increased late-distal convoluted tubule cation channel insertion
