A 50-Year-Old Man with Polycystic Kidney Disease Arrives at the Clinic

A 50-year-old man with polycystic kidney disease arrives at the clinic complaining of constant, severe pain in his shoulders, arms, and legs. Long-standing hypertension treated with ramipril is part of the patient's medical history. The blood pressure is 150/85 mm Hg, and the pulse rate is 78 beats per minute. The cardiopulmonary exam is normal. Large, palpable renal masses are discovered during an abdominal examination. There is some bilateral lower-extremity edema. Two years ago, laboratory results revealed a blood urea nitrogen level of 25 mg/dL and a creatinine level of 2.3 mg/dL. The following are the most recent laboratory results: Which of the following metabolic states is most likely present in this patient?

A) A
B) B
C) C
D) D
E) E

Correct Answer:

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