A 56-year-old male with diabetes mellitus, hypertension, and chronic renal insufficiency presents for follow-up of his chronic medical conditions. Results of his most recent metabolic panel included an estimated glomerular filtration rate of 30 mL/min/1.73 m (N >60) and a calcium level of 10.4 mg/dL (N 8.5–10.2). Medication reconciliation reveals he is not taking the sevelamer (Renagel, Renvela) prescribed by the consulting nephrologist. You explain to the patient that he should be taking sevelamer to lower his serum calcium. The drug accomplishes this by A) blocking the effect of parathyroid hormone B) blocking excessive vitamin D levels, thus decreasing intestinal calcium absorption and increasing renal calcium excretion C) blocking intestinal absorption of phosphate, which lowers parathyroid hormone secretion D) directly blocking excessive calcium absorption in the intestines E) directly increasing the renal excretion of both calcium and phosphate
Posted on: Sat, 01 Nov 2014 15:29:59 +0000
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