INS and Hyperkalemia: A repeat biochemistry profile was performed 1 h after insulin administration and indicated worsening azotemia (BUN concentration, 151 mg/dL; serum creatinine concentration, 4.0 mg/dL compared with admission results of 122 and 3.4 mg/dL, respectively), progressive hyperphosphatemia (15.8 mg/dL as compared with 10.6 mg/dL at admission), and slight improvement in severe hyperkalemia (8.5 mEq/L; admission, 9.7 mEq/L).