Specimen Name Result Units Range
Plasma Sodium 146 mmol/L (135-145)
Potassium 2.7 mmol/L (3.5-5.5)
Chloride 113 mmol/L (100-109)
Bicarbonate 18 mmol/L (22-32)
Anion Gap 18 mmol/L (7-17)
Glucose 18 mmol/L (3.8-5.5)
Urea 16.0 mmol/L (2.7-7.2)
Creatinine 180 μmol/L (60-110)

23yo female with known diabetes

Admitted previous evening with DKA.
Hyperosmolar Hypernatraemia & Hypokalaemia
  • Corrected [Na+] ≈ 149 mmol/L
    • 2° renal H2O loss & "isotonic" IVT (N.Sal ≈ 154 mmol/L)
  • Normal U/C ratio & AG suggests ketoacidosis adequately treated
  • Persisting acidaemia ∝ hyperchloraemia & renal HCO3- loss

 

Hypokalaemia 2°

  • diuresis & renal losses
  • correction of acidaemia
  • ICF shift with insulin & glucose

NB:

  • continued IVT should be with ½N-saline
  • plus adequate K+ replacement (large total body deficit)