Clinical Case Presentation 2 A 65-year-old man presents with back pain and unexplained anemia. Upon evaluation, the following laboratory values are obtained: Na+ 139 mmol/L, K+ 3.4 mmol/L, HCO3– 18 mmol/L, Cl– 108 mmol/L, glucose 104 mg/dL, creatinine 2.2 mg/dL, and total protein 10.1 g/dL. An arterial blood gas test shows pH 7.35 and pCO2 33 mmHg. The urinalysis shows 1+ glucose and a urine pH of 5.5. The patient is diagnosed with multiple myeloma complicated by evidence of proximal RTA in association with generalized dysfunction of the proximal tubule (Fanconi syndrome).