Patho ASAP

A 67-year-old man with stage 4 chronic kidney disease, hypertension, type 2 diabetes mellitus,

and anemia of chronic kidney disease comes to the office for routine follow-up. Laboratory

findings include the following:

Sample Nephrology Questions & Critiques

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Serum

Calcium 9.4 mg/dL

Creatinine 3.24 mg/dL

Potassium 3.8 mEq/L

Bicarbonate 19 mEq/L

Fasting glucose 63 mg/dL

Phosphate 4.2 mg/dL

Albumin 4.0 g/dL

Blood urea nitrogen 36 mg/dL

Hematocrit 33.1%

Hemoglobin 11.1 g/dL

Mean corpuscular volume 94 μm3

Estimation of glomerular filtration rate, calculated using the Modification of Diet in Renal

Disease (MDRD) Study equation, is 19 mL/min/1.73 m2

. Measurement of which of the following

additional laboratory values is most appropriate to screen for renal osteodystrophy in this

patient?

(A) Erythrocyte sedimentation rate

(B) Serum C-reactive protein level

(C) Serum intact parathyroid hormone level

(D) Serum thyroid-stimulating hormone level

(E) Serum vitamin B12 level