I enjoyed the review of chronic renal insufficiency by Rahman and Smith,1 but found the omission of one cause of renal insufficiency to be disheartening. Herein I describe a case of nephropathy whose cause was only discovered only after the physician was guided by a subtle laboratory finding to question the patient carefully about her medical and social history.
Hirsch RL. Chronic Renal Insufficiency. Arch Intern Med. 1999;159(7):757. doi: