What is the clinical interpretation of the following laboratory results for a 19-year-old female: normonatremia (Sodium), normokalemia (Potassium), hyperchloremia (Chloride), normal CO2 levels, low Anion Gap, normoglycemia (Glucose), normal Blood Urea Nitrogen (BUN) levels, normal Creatinine levels, normal estimated Glomerular Filtration Rate (eGFR), normal Calcium levels, normal Aspartate Aminotransferase (AST) (SGOT) levels, normal Alanine Aminotransferase (ALT) (SGPT) levels, slightly elevated Alkaline Phosphatase levels, normal Total Protein levels, normal Albumin levels, and normal Total Bilirubin levels?

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From the Research

The patient's lab results show mostly normal values with one abnormality: a low anion gap of 5 (reference range 6-18), which is a relatively uncommon finding and may not require immediate intervention given the otherwise normal lab profile, including excellent kidney function (eGFR 131) 1. The low anion gap may be due to laboratory error, hypoalbuminemia (though albumin is normal here at 4.6 g/dL), or the presence of unmeasured cations in the blood.

  • The patient's electrolytes, kidney function tests, liver function tests, and glucose are within normal limits.
  • The patient's kidney function is excellent, with an eGFR of 131, which suggests that the low anion gap is unlikely to be related to kidney disease 1.
  • The patient's liver function tests are also normal, which suggests that the low anion gap is unlikely to be related to liver disease 2.
  • It would be reasonable to repeat the electrolyte panel to confirm this result, as suggested by the most recent study on kidney function and electrolyte abnormalities 1.
  • If the low anion gap persists, further evaluation might be warranted to identify potential causes such as multiple myeloma, bromide or lithium ingestion, or other rare conditions.
  • The patient should discuss this finding with their healthcare provider at their next visit, but it doesn't appear to represent an urgent clinical concern given the otherwise normal lab profile.
  • A healthy dietary pattern, as suggested by the literature review on diet and kidney function, may help to maintain normal kidney function and prevent kidney disease 1.

References

Research

Diet and Kidney Function: a Literature Review.

Current hypertension reports, 2020

Research

Kidney Injury and Electrolyte Abnormalities in Liver Failure.

Seminars in respiratory and critical care medicine, 2018

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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