Neil Shadbeh Evans, MD; Paul Aronowitz, MD; Timothy E. Albertson, MD, PhD
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JAMA. 2023;330(20):2016-2017. doi:10.1001/jama.2023.19032
On day 7 after hospital admission, a patient with end-stage kidney disease prescribed sevelamer, hydrocodone-acetaminophen, hydromorphone, and chewable lanthanum tablets developed intermittent apneic episodes, bilateral rhonchi, and responsiveness to verbal commands only with deep painful stimulus; a chest radiograph showed 4 radio-opaque coin-shaped opacities in the stomach. What is the diagnosis and what would you do next?