A patient with chronic renal failure presents with hyperphosphatemia. What electrolyte imbalance is most expected along with it?

Correct option is B

Hyperphosphatemia binds free calcium and reduces serum calcium levels. In renal failure, phosphate retention leads to secondary hypocalcemia.
Explanation of options: (a) ✘ Hypercalcemia is seen in hyperparathyroidism, not phosphate retention. (b) ✔ Correct; phosphate ↑ → calcium ↓ (inverse relationship). (c) ✘ Sodium levels are independent of phosphate balance. (d) ✘ Potassium is usually high in renal failure, not low.