A 70 year old with acute shortness of breath.
Blood tests show:Acute compensated raised anion gap metabolic acidosis
severe hyperkalemia – protect myocardium, reduce K and check renal function
total body K likely normal – shift due to acidaemia
Other causes – ketones, lactate, renal failure, toxins
delta ratio = 0.7, consider HAGMA and NAGMA however AG is often less than 0.8 in renal failure
This patient’s Creatinine was >1000 – requires dialysis