A 68-year-old male was admitted to a hospital with febrile neutropenia after chemotherapy for extra skeletal osteosarcoma and was found to have acute renal insufficiency, hypokalemia, and nongap metabolic acidosis. Past medical history (PMH) History was remarkable for extra skeletal osteosarcoma treated with left nephrectomy, splenectomy, and partial resection of stomach, pancreas, and colon.
Physical Examination VSS His physical examination was remarkable for 3 + bilateral pedal edema Medications With recurrence of disease, he failed treatment with Docetaxel and his chemotherapy was then changed to Doxorubicin and Ifosfamide Prior to receiving Ifosfamide, the patient's baseline creatinine was 1.2 mg/dL and serum bicarbonate was normal He denied any recent NSAID use or iodinated IV contrast administration The patient received his third cycle of chemotherapy approximately 3 weeks prior…
