Specimen Name Result Units Range
Plasma Sodium 142 mmol/L (135-145)
Potassium 5.5 mmol/L (3.5-5.5)
Chloride 101 mmol/L (100-109)
Bicarbonate 15 mmol/L (22-32)
Glucose 6.0 mmol/L (3.8-5.5)
Urea 63 mmol/L (2.7-7.2)
Creatinine 490 μmol/L (60-110)

45yo female with history of longstanding severe headaches.

Note - old profile (pre-1980) !
Analgesic Nephropathy
  • ** was a common cause CRF (papillary necrosis / interstitial nephritis)
    → ↓↓incidence ∝ ↓phenacetin use ≈ 1970-80s
  • uraemia & high creatinine
  • metabolic acidosis with ↑AG ≈ 31
  • AG rarely > 24 in CRF alone, ∴ potential superimposed disorder?
    • salicylate ingestion
    • lactic acidosis

 

Metabolic Acidosis & Hyperkalaemia

  • primary metabolic acidosis → initial buffering in ICF ± bone
    → ↑[K+] ≈ 0.5 mmol/L per ↓pH ≈ 0.1
  • raised AG
    • CRF
    • DKA
    • lactic acidosis, etc.
  • normal AG - exogenous HCl