Acute Kidney Injury in a Patient with Metastatic Pancreatic Neuroendocrine Tumor

A 51-year-old man with a metastatic pancreatic neuroendocrine tumor was admitted with failure to thrive and AKI.Despite treatment with distal pancreatectomy, a somatostatin analog, and peptide receptor radionuclide therapy, his cancer metastasized to his liver and abdominal lymph nodes.Initial serum creatinine was 3.0 mg/dl from a normal baseline, serum albumin 3.4 g/dl, aspartate aminotransferase 684 U/L, and alanine aminotransferase 296 U/L.Serum potassium, phosphorus, calcium, and total bilirubin were