Acid Base Question - low SIG

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AZ1986

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Hi there,

I have a question about a patient of mine.
A 93y old woman with acute postrenal kidney injury.
She got double pigtail stents and developed a urosepsis. Diuresis was starting after the intervention.
The blood gas analysis and the labs are below. (in German)

Acid base:
BE = -4.5mmol/l
SID = ~25mmol/l
albumine = 37,2g/l
lactate = 3,8 mmol/l
SIG = -9.75

I calculated the SIG with "-9.75".
How can you explain this?
I expected a BE of -12 to -16, because of hyperchloremic, lactat-acidosis.
Maybe even lower with uremia.

Thanks in advance.

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