Case Presentation: A 26-year-old male with no significant past medical history was intubated due to respiratory failure from cocaine and fentanyl overdose. Admission labs showed severe rhabdomyolysis (creatinine kinase> 22K U/L), hyperphosphatemia (>20mg/dL) and hyperkalemia (>10mmol/L) with creatinine 2.9mg/dL. ICU course was complicated by hypoalbuminemia, chronic hypocalcemia (corrected calcium-7.6-8.4 mmol/L) and chronic hyperphosphatemia (5.6-10mg/dL). He [...]