Published in:
08-01-2024 | Metabolic Acidosis | Nephrology Zebra
Nephrology picture: metabolic acidosis with acute tubular injury—a noteworthy case
Authors:
Gauri Gaur, Lakshya Kumar, Kiran Preet Malhotra, Anukriti Subhagya, Durgesh Pushkar
Published in:
Journal of Nephrology
|
Issue 2/2024
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Excerpt
An 18-year-old female presented to the Emergency Medicine Department with possible poisoning and history of sudden onset confusion, lethargy and anuria. On examination, the patient had altered sensorium and tachypnea. Investigations revealed neutrophilic leukocytosis (absolute count 13,776/cmm). Hemoglobin was 10.4 g/dL and platelets 230,000/cmm. Renal function was impaired (creatinine 9.7 mg/dL, urea 70.7 mg/dL). Liver function tests were normal. Arterial blood gas analysis revealed pH 7.1, pO2 109 mmHg and bicarbonate 12 mmol/L. Serum chemistry showed sodium 138 mmol/L, potassium 3.6 mmol/L, chloride 108 mmol/L, calcium 2.7 mmol/L and lactate 2.2 mmol/L. Osmolality was 314 mOsm/kg. Anion Gap was calculated to be 18 mmol/L. …