A 59-year-old man with no medical history presented to the emergency department for severe constipation. The patient reported back pain during the previous 2 weeks, which he treated with nonsteroidal anti-inflammatory drugs and acetaminophen. Also of note was recent oliguria. Physical examination findings were unremarkable except for new-onset hypertension, with blood pressure of 160/90mmHg. Blood tests showed an elevated serum creatinine level of 7.3mg/dL (corresponding to estimated glomerular filtration rate [eGFR] of 8mL/min/1.73m2 as calculated by the 4-variable MDRD [Modification of Diet in Renal Disease] Study equation), hypercalcemia (calcium, 15.8mg/dL), and hemoglobin level of 8.8g/dL.