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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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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
(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

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