A 62-year-old woman presented to the emergency department with abdominal pain and diarrhea. She collapsed while waiting for a bed and was unresponsive. In the resuscitation room, she was found to be in ventricular tachycardia and was defibrillated to normal sinus rhythm. Her labs showed hypokalemia, hypocalcemia, and metabolic acidosis. She had a history of missing her most recent hemodialysis appointment.