What is A 53-year-old woman with a past medical history of chronic kidney disease due to diabetic nephropathy is noted to have hyperphosphatemia and hypocalcemia on routine electrolyte measurement. The disturbance is likely a result of metabolic bone disease seen in patients with chronic kidney disease. Which of the following findings is most likely associated with this electrolyte disturbance? and explain in detail?
Neuromuscular irritability is a clinical feature of hypocalcemia if it is severe enough. Hyperphosphatemia rarely causes any symptoms directly. Its secondary effects on calcium can result in hypocalcemic tetany or metastatic calcification. The usual cause of hyperphosphatemia is uremia. Anorexia, nausea, and vomiting are not usual clinical features of hypocalcemia or hyperphosphatemia. They may occur if the patient has advanced chronic kidney disease and associated uremia. Hypocalcemia prolongs the QT interval, and in severe cases predispose to polymorphic VT (Torsades) but this is a rare occurrence. For the majority of patients with hypocalcemia there are no associated tachyarrhythmias.