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High anion gap metabolic acidosis is a form of metabolic acidosis characterized by a high anion gap (a medical value based on the concentrations of ions in a patient's serum). Metabolic acidosis occurs when the body produces too much acid , or when the kidneys are not removing enough acid from the body.
For a list of the common anions responsible, see high anion gap metabolic acidosis. KULT is probably the easiest of the mnemonics to use (Ketones, Uremia, Lactate, Toxins). Toxins are an uncommon cause of high anion gap metabolic acidosis – a list of the commonest toxins is ACE GIFTs [ibid]. Metformin as a pure toxicological cause is ...
English: Causes of high anion-gap metabolic acidosis Mnemonic "CAT MUDPILES": Carbon monoxide, Cyanide, Congenital; heart failure Aminoglycosides; Teophylline, Toluene (Glue-sniffing)
Hyperparathyroidism – can cause hyperchloremia and increase renal bicarbonate loss, which may result in a normal anion gap metabolic acidosis. Patients with hyperparathyroidism may have a lower than normal pH, slightly decreased PaCO2 due to respiratory compensation, a decreased bicarbonate level, and a normal anion gap.
The mnemonic "MUDPILES" is used to remember the causes of a high anion gap. [ 1 ] M - methanol / metformin U - uremia D - diabetic ketoacidosis P - paraldehyde / propylene glycol I - Infection / ischemia / isoniazid L - lactate E - ethylene glycol / ethanol S - salicylates / starvation
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4, which rise with disease or intoxication, cause loss of HCO − 3 due to bicarbonate's activity as a buffer (without a concurrent increase in Cl − ). Thus, finding a high anion gap should result in a search for conditions that lead to excesses of the unmeasured anions listed above.
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