Specimen Name Result Units Range
Plasma Sodium 132 mmol/L (135-145)
Potassium 3.1 mmol/L (3.5-5.5)
Chloride 99 mmol/L (100-109)
Bicarbonate 18 mmol/L (22-32)
Glucose 8.2 mmol/L (3.8-5.5)
Urea 13.4 mmol/L (2.7-7.2)
Creatinine 170 μmol/L (60-110)
Phosphate 2.01 mmol/L (0.80-1.45)
Total Calcium 3.21 mmol/L (2.10-2.55)
Albumin 43 g/L (34-48)
ALP 97 U/L (30-110)

59yo female with polyuria.
Exogenous Vitamin D Excess
  • polyuria 2° hypercalcaemia → nephrogenic DI
  • ↑thirst → polydipsia but inadequate replacement & pre-renal impairment
  • high Ca++ & PO4
    • PTH excess would → ↓PO4
    • malignant/bone origin would → ↑ALP
  • K+ wasting 2° polyuria

 

Aetiology Hyperphosphataemia:

  1. Acute → release from cells
    • metabolic acidosis, DKA
    • rhabdomyolysis
    • ischaemic gut
    • severe catabolic states
    • tumour lysis syndrome
  2. Chronic
    • chronic renal failure
    • hypoparathyroidism / pseudo-hypoparathyroidism
    • vitamin D toxicity
    • excess intake:
      • TPN, IVT
      • diphosphonate therapy