Specimen Name Result Units Range
Plasma Sodium 150 mmol/L (135-145)
Potassium 2.8 mmol/L (3.5-5.5)
Chloride 90 mmol/L (100-109)
Bicarbonate 37 mmol/L (22-32)
Glucose 5.0 mmol/L (3.8-5.5)
Urea 25 mmol/L (2.7-7.2)
Creatinine 250 μmol/L (60-110)
Osmolality 335 mmol/kg (275-295)
Urine Sodium 5 mmol/L (> 20)
Osmolality 710 mmol/kg

35yo male with abdominal and vomiting.
Hypokalaemic Metabolic Alkalosis

Prolonged Vomiting

  • loss of HCl → metabolic alkalosis alkalosis
  • urea/creat ratio ∝ hypovolaemia & pre-renal AKI

 

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 transfusion - citrate metabolism & acidosis correction