{"text":"NHS Confidentlal: Paraonal data about a patient \nNHS Lanarkshire Monkiands Hospital N H S \nwwiv.nhslanarkshire. org uk. ) Xl.ogifscourt Avenue ) \nRenal Medicine irdrie %W o \n01698752428 ML6 OIS \nRenal : Lanarkshire \nDr R MacInnes ) Date Dictated: 29\/08\/2022 \nKilsyth Medical Partnership : Date Typed: 30\/08\/2022 \nKilsyth Community Health Centre Ref! - 2872350 \nAirdrie Road Letter Ref: CN\/AT \n: : Clinic Daie: 25\/08\/2022 \nK]]Sylh CHI Barcode: \nG65 9JE \n~ | \n\u2018 *12098234053n \nConsultant: Dy Claire Nolan \nDe\u00e9ar Dr, \nPatient Name: Patricia Hunt \nPatient date of birth: 12\/09\/1982 \nPatient Address: 22 Cuibmuir View, Croy, Glasgow, G65 9HH \n[ met with Miss Fuat at my general nephrofogy clinic today, the 25\" of August. Ms Hunt is & 39-year-old lady who has \nnephrocalcinosis and may possibly have disial 1enai tubular acidosis, \n[ met with her when she was an idpatient in Monklands recently, with acute kidney injury, hypokalaemia and fow \nbicarbonate. The overall picture was that of a mixed metabolic acidosts, however I note that her winary anion gap at that \ntime was positive. She had further investigations and a 24-hour urinary collection for calcium, phosphate and oxalate \nwere all nomal. Her 24-hour colleetion for citrate is outstanding and it will be intercsting 10 see it this demonstrates high \nhypocitraturia. Cortisol, serum ACE, and myeloma sereen were alf negative, as were GN sereen including ENA's, \nMiss Hunt weighs 51.4kgs and an eating disorder would come into the differential diagnosis here. I chalted to Miss Hunt \nabout this today angd she admitted that in the past she has had eating disorder though feels things are better in that regard \nat present. Regardless, I think she should continue her sadium bicarbonale capsules at present at 1 gram bd, as this \nappears to be keeping her potassium and bicarbonate satisfactory for the time being, \nT will catch up with Miss Hunt fairly soon, if, as expected, she also has hypocitraturia there will be dietary advice to \nimpart and possibly a change of sodium bicarbonate to potassium citrate instead. \nIwonder if the practice might be able to help with an early moming urine pH reading, If this can't be done at the practice \n(and the result forwarded to me) then I will arrange for it to be done at Monkiands hospital. \nThanks for your help. \nYours sincerely \nDz Claire Nolan \nConsultant Nephrologist and Physician \nAuthoyised on 30\/08\/2022 12:35:18 by Claire Nolan. \nRecent Results \nDale Thre Test Result. Units \n25\/08\/2022 18:08 Potassium 4.7 mmalfl. \n261082022 18:08 Bicarbonale 23 mmoliL. \n2510812022 8:05 Urea 8.1 mmoliL \n2510812022 18:09 Crealining 133 miccomolfl \n25\/08\/2022 18:05 eGFR 43 mi\/mind{.73m2 \n1410612022 28:18 Glucose 87 mmolil, \n2510872022 18:05 Albumin 39 giL \n25\/08\/2022 18:05 Adljusied Calelum 225 mmolklL \n1370812022 08:05 Phosphale 1.78 mmoliL, \n1340812022 08:05 PTH 65 picomal. 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