A nurse is reviewing the laboratory results for a client who has chronic kidney disease. Which of the following laboratory findings should the nurse expect?

A. Decreased BUN: In chronic kidney disease (CKD), the kidneys lose the ability to effectively excrete nitrogenous waste products. This leads to an accumulation of urea in the blood, resulting in an increased—not decreased—BUN level as renal function declines. B. Hypokalemia: CKD typically causes impaired potassium excretion, leading to hyperkalemia rather than low potassium levels. Hypokalemia is more commonly associated with diuretic use or gastrointestinal losses, not reduced renal clearance. C. Elevated creatinine: Creatinine rises as glomerular filtration rate (GFR) declines in chronic kidney disease. Because creatinine is filtered almost entirely by the kidneys, persistently elevated levels are a key laboratory indicator of chronic renal impairment. D. Decreased urine specific gravity: In CKD, urine specific gravity often becomes fixed around 1.010 (isosthenuria) rather than simply decreased. This reflects the kidneys’ inability to concentrate or dilute urine appropriately, making this finding less consistently expected than elevated creatinine.