Our patient had a number of these factors potentiating this event: medications involved with inhibition of the renin-angiotensin-aldosterone system (RAAS), medications involved with distribution and shift changes of potassium (intracellular to extracellular), exogenous potassium supplementation leading to increased serum concentrations, and acute kidney injury of unknown etiology that decreased potassium excretion. This evidence concerns the gene REN and acute kidney injury.