72 year-year-old man with history of type II DM and has a single kidney. Presented with 2 weeks of diarrhoea. He has been in bed for 2 weeks. Unresponsive. Last proper meal was 2 weeks ago. His Venous blood gases showed the following:

PH = 6.782

pCO2 = 17 mmHg

pO2 = 75 mmHg

HCO3 = 2.5 mmol/L

Na = 144 mmol/L

K = 6.5 mmol/L

Cl = 104 mmol/L

Ca = 1.3 mmol/L

Hb = 136 g/L

Lactate = 19 mmol/L

Glucose = 13.2 mmol/L

Creatinine = 1191 umol/L

Interpret these results and how will you treat this patient?

Thanks to Dr Robert Evans for providing the details for this case.