Specimen Name Result Units Range
Plasma Sodium 141 mmol/L (135-145)
Potassium 3.1 mmol/L (3.5-5.5)
Chloride 84 mmol/L (100-109)
Bicarbonate 44 mmol/L (22-32)
Glucose 5.6 mmol/L (3.8-5.5)
Urea 18.0 mmol/L (2.7-7.2)
Creatinine 210 μmol/L (60-110)

43yo male with abdominal pain.

Worse recently with protracted vomiting.
Acute on Chronic DU

Hypochloraemic Metabolic Alkalosis

  • ↑ HCO3- → alkalosis ∝ H+ loss
  • ↓ K+ ∝ GI loss
  • U:C ratio (≈ 86) → likely pre-renal AKI ∝ hypovolaemia
  • combined hypovolaemia & hypokalaemia maintaining alkalosis

 

Hypokalaemic Metabolic Alkalosis
Diuretics (esp. loop agents) - low Na+, Cl- / high urea
Mineralocorticoid excess - normal-high Na+, Cl- / normal urea
Vomiting / Gastric outlet obs. - very low Cl- / low-normal Na+ / high urea
Diarrhoea / laxatives - low Cl- / normal Na+ / high urea
Post massive blood Tx - citrate metabolism & acidosis correction