Specimen Name Result Units Range
Plasma Sodium 143 mmol/L (135-145)
Potassium 5.0 mmol/L (3.5-5.5)
Chloride 119 mmol/L (100-109)
Bicarbonate 15 mmol/L (22-32)
Anion Gap 14 mmol/L (7-17)
Urea 26 mmol/L (2.7-7.2)
Creatinine 300 μmol/L (60-110)

57yo female with chronic pain, malaise & weakness.
Hyperchloraemic acidosis / Analgesic Nephropathy
  • chronic tubulointerstitial nephritis ∝ chronic use of analgesics
    * phenacetin/bucetin, NSAIDs, paracetamol
  • AKI / chronic renal failure → usually mild ↑AG ≤ 25 mmol/L
  • picture effectively ≅ RTA

 

Aetiology - hyperchloraemic acidosis:

  • any disorder → 1° bicarbonate loss (renal / non-renal)
  • exogenous HCl or KCl - TPN, AAs, etc.
  • partially treated DKA