I got this one wrong. I thought there is hyperkalemia which leads to alkalosis
Renal damage from PKD can ultimately cause chronic renal insufficiency. This impairs the ability of the kidney to excrete phosphorus and reabsorb HCO3. Elevated phosphate levels in the blood triggers release of FGF-23 from bone, which lowers vitamin D production and decreases calcium absorption in the intestine. The resulting hypocalcemia and hyperphosphatemia will lead to an increase in the secretion of PTH.
submitted by ∗aneurysmclip(209)
basically polycystic kidneys won't work properly, they've hinted at this with the s.creat of 4mg/dl. thus the kidney won't do what its supposed to do. REMEMBER to check whether they are asking SERUM changes or URINE changes
Kidneys normal function - reabsorb HCO3- , its not doing that now > decreased HCO3
PTH - would cause increased Calcium reabsorption in kidneys, but kidneys aren't able to reabsorb calcium > PTH responds to low calcium levels and levels increase
PO4 ties into PTH as well, PTH acts be DECREASING PO4 reabsorption. Since kidneys aren't working ie: not responding to PTH > there would be increase in PO4