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A 57-year-old woman with hypertension and chronic renal insufficiency who had refused dialysis for two years was found in respiratory distress after one week of upper respiratory symptoms due to a viral infection. Before admission to the hospital, she had an asystolic cardiac arrest but was resuscitated by emergency medical technicians. She was admitted to the intensive care unit and required vasopressor support. On physical examination, diffuse deposits of tiny white crystalline material were observed on her skin (Panels A and B). Initial laboratory studies showed a blood urea nitrogen level of 208 mg per deciliter (74.3 mmol per liter), . . . [Full Text of this Article] |
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