Clinical Scenario:
A 14-year-old boy undergoing regular follow-up for chronic kidney disease complains of increasing numbness around the mouth and painful muscle spasms over the last two days. On examination, Chvostek’s sign is positive. Laboratory investigations show:
- Serum calcium: 6.9 mg/dL
- Serum phosphate: 7.4 mg/dL
- Serum creatinine: 5.2 mg/dL
Which complication of chronic kidney disease is the most likely cause of these findings?
A. Hyperkalemia
B. Metabolic acidosis
C. Renal osteodystrophy
D. Uremic encephalopathy
E. Volume overload
Correct answer & Explanation:
correct Answer: C. Renal osteodystrophy
Explanation: Chronic kidney disease causes phosphate retention and reduced calcitriol production, resulting in hypocalcemia and secondary hyperparathyroidism. Symptomatic hypocalcemia with tetany is a manifestation of renal osteodystrophy (CKD-MBD).
