Specimen Name Result Units Range
Plasma Sodium 151 mmol/L (135-145)
Potassium 1.9 mmol/L (3.5-5.5)
Chloride 81 mmol/L (100-109)
Bicarbonate 61 mmol/L (22-32)
Anion Gap 11 mmol/L (7-17)
Glucose 6.2 mmol/L (3.8-5.5)
Urea 9.5 mmol/L (2.7-7.2)
Creatinine 110 μmol/L (60-110)
Urine Sodium 38 mmol/L (> 20)
Chloride 54 mmol/L
Osmolality 450 mmol/kg

72yo male with chronic DU.
Exogenous Alkali Ingestion

Vomiting will also produce a hypochloraemic metabolic alkalosis with hypernatraemia, however, would:

  • not result in such a marked HCO3- rise, and
  • tend to cause:
    • hypovolaemia
    • elevated urea/creatinine
    • very low urinary Na+ & higher urine osmolality

 

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