慢性肾衰竭患者，血压 180/120mmHg,贫血外观，全 身中度水肿，鼻出血，尿素氮 50mnio]/L，血钾6. 17mmol/L,钙2. 0丨nmol/L, C02结合力13m.noI/L,在纠酸过程中突然手足搐搦，意识淸楚。典原W可能是

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