Anion Gap
Calculates the anion gap to check for metabolic acidosis.
Anion Gap = Na - (Cl + HCO3-) Delta Gap = Anion Gap - 12 (nl anion gap)
Anion Gap Metabolic Acidosis: MUDPILERS
- Methanol
- Uremia
- DKA/Alcoholic KA
- Paraldehyde
- Isoniazid
- Lactic Acidosis
- Etoh/Ethylene Glycol
- Rhabdo/Renal Failure
- Salicylates
Non-Anion Gap Acidosis: HARDUPS
- Hyperalimentation
- Acetazolamide
- Renal Tubular Acidosis
- Diarrhea
- Uretero-Pelvic Shunt
- Post-Hypocapnia
- Spironolactone
Acute Respiratory Acidosis (Chronic Respiratory Acidosis = COPD/restrictive lung dz): any hypoventilation state
- CNS Depression (drugs/CVA)
- Airway Obstruction
- Pneumonia
- Pulmonary Edema
- Hemo/Pneumothorax
- Myopathy
Metabolic Alkalosis: CLEVER PD
- Contraction
- Licorice
- Endo: (Conn's, Cushings, Bartter's)
- Vomiting
- Excess Alkali
- Refeeding Alkalosis
Respiratory Alkalosis: CHAMPS (think speed up breathing)
- CNS disease
- Hypoxia
- Anxiety
- Mech Ventilators
- Progesterone
- Salicylates/Sepsis
| Delta Ratio... | Suggests... |
|---|---|
| < 0.4 | Hyperchloremic normal anion gap acidosis |
| < 1 | High AG & normal AG acidosis |
| 1 to 2 |
Pure Anion Gap Acidosis Lactic acidosis: average value 1.6 DKA more likely to have a ratio closer to 1 due to urine ketone loss |
| > 2 | High AG acidosis and a concurrent metabolic alkalosis or a pre-existing compensated respiratory acidosis |
Posted in: Endocrine/Metabolic • Endocrinology • Nephrology • Renal
