Specimen Name Result Units Range
Plasma Sodium 126 mmol/L (135-145)
Potassium 6.2 mmol/L (3.5-5.5)
Chloride 85 mmol/L (100-109)
Bicarbonate 23 mmol/L (22-32)
Anion Gap 24 mmol/L (7-17)
Glucose 104 mmol/L (3.8-5.5)
Urea 21.1 mmol/L (2.7-7.2)
Creatinine 171 μmol/L (60-110)
Urate 0.55 mmol/L (0.20-0.40)
Phosphate 2.02 mmol/L (0.80-1.45)
Total Calcium 2.63 mmol/L (2.10-2.55)
Ionized Calcium 1.27 mmol/L (1.07-1.27)
Albumin 37 g/L (34-48)
Globulins 50 g/L (22-35)
Total Protein 87 g/L (60-80)
Total Bilirubin 9 μmol/L (6-24)
GGT 29 U/L (< 60)
ALP 230 U/L (30-110)
ALT 29 U/L (< 55)
AST 16 U/L (< 45)
LDH 198 U/L (110-230)

59yo female BIBA unconscious & mildly hypotensive.
Hyperglycaemic Hyperosmolar Non-ketotic Coma
  • Hyperglycaemia : marked & therefore diabetic disorder
  • Hyperosmolar 'hyponatraemia':
    • corrected [Na+] ≈ 158 mmol/L
    calculated osmolality: = 1.86*(Na+K) + urea + glucose + 10
    = 1.86*(126+6.2) + 21.1 + 104 + 10
    ≈ 381 mmol/L
  • Pre-renal AKI : U/C ratio > 100 ∝ likely hypovolaemia
  • Metabolic acidosis : mild ↑AG ≅ AKI with normal HCO3-

Hyperosmolar Hyponatraemia:

  1. Glucose
    • DKA, HONC
    • 'Corrected' [Na+] ≈ [Na+]Pl + [BGL-10]/3
  2. Urea:
    • esp. salt-losing nephritis
    • high [K+], creatinine, urea
  3. Others:
    • mannitol
    • glycine port-TURP
    • glycerol, sorbitol, ethanol, methanol