A 46-year-old man with crush injury is admitted after being trapped under debris for several hours. He has dark urine and severe muscle pain. Laboratory studies show potassium 7.4 mEq/L, calcium 7.4 mg/dL, phosphate 6.9 mg/dL, creatine kinase markedly elevated, and creatinine 2.9 mg/dL. Which of the following best explains the low calcium level in this patient?

1. A)Increased distal nephron calcium excretion due to thiazide therapy
2. B)Loss of PTH due to pituitary dysfunction
3. C)Reduced albumin synthesis from cirrhosis
4. D)Excess calcitonin release from the thyroid
5. E)Calcium deposition in damaged muscle and binding by released phosphateGABARITO