A 61-year-old man with advanced chronic kidney disease presents with fatigue and anorexia. Vital signs show BP 158/92 mmHg, HR 88/min, RR 22/min, temperature 37.1°C, and SpO2 98% on room air. He has bilateral lower extremity edema but denies dyspnea. Laboratory studies reveal BUN 88 mg/dL, creatinine 7.2 mg/dL, Na+ 139 mEq/L, Cl− 101 mEq/L, and HCO3− 14 mEq/L. Which acid-base disorder best explains these findings?
- A)Excess aldosterone activity
- B)Hyperventilation from anxiety
- C)Loss of bicarbonate in stool
- D)Hydrogen ion loss from the stomach
- E)Accumulation of unmeasured organic anionsGABARITO
Explicação
Advanced renal failure causes retention of sulfates, phosphates, and organic acids, producing an anion gap metabolic acidosis. The low bicarbonate in the setting of severe uremia and renal insufficiency is classic for uremic acidosis. Ver explicação completa e trilha adaptativa →