Specimen Name Result Units Range
Plasma Sodium 141 mmol/L (135-145)
Potassium 4.3 mmol/L (3.5-5.5)
Chloride 116 mmol/L (100-109)
Bicarbonate 15 mmol/L (22-32)
Anion Gap 14 mmol/L (7-17)
Glucose 5.4 mmol/L (3.8-5.5)
Urea 31 mmol/L (2.7-7.2)
Creatinine 820 μmol/L (60-110)
Osmolality 305 mmol/kg (275-295)
Urate 0.40 mmol/L (0.20-0.40)
Phosphate 0.94 mmol/L (0.80-1.45)
Total Calcium 2.22 mmol/L (2.10-2.55)
Albumin 42 g/L (34-48)
Globulins 23 g/L (22-35)
Total Bilirubin 9 μmol/L (6-24)
GGT 8 U/L (< 60)
ALP 154 U/L (30-110)
AST 15 U/L (< 45)
LDH 159 U/L (110-230)
Cholesterol 4.8 mmol/L (3.5-5.5)

79yo female known to Renal Unit @RAH.
Chronic Renal Failure

Elevated creatinine, urea & osmolality.

However, hyperchloraemia / normal AG metabolic acidosis - cause??

Hyperchloraemia is due to:

  1. Any hypernatraemic state
  2. Respiratory alkalosis
  3. Metabolic acodosis with normal AG:
    • Renal
      • RTA
      • CA inhibitors
      • K+-sparing diuretics
      • early uraemia
    • Extra-Renal
      • diarrhoea
      • hypoadrenalism
      • ureterosigmoidoscopy
      • treated DKA
      • exogenous HCl (TPN/AAs, NH4Cl, HCl)