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The differential diagnosis of normal anion gap acidosis is relatively short (when compared to the differential diagnosis of acidosis): Hyperalimentation (e.g. from TPN containing ammonium chloride) Chloride administration, often from normal saline; Acetazolamide and other carbonic anhydrase inhibitors; Renal tubular acidosis [1]
The magnitude of this difference (i.e., "gap") in the serum is calculated to identify metabolic acidosis. If the gap is greater than normal, then high anion gap metabolic acidosis is diagnosed. The term "anion gap" usually implies "serum anion gap", but the urine anion gap is also a clinically useful measure. [4] [5] [6] [7]
In general, the cause of a hyperchloremic metabolic acidosis is a loss of base, either a gastrointestinal loss or a renal loss [citation needed]. Gastrointestinal loss of bicarbonate (HCO − 3) [citation needed] Severe diarrhea (vomiting will tend to cause hypochloraemic alkalosis) Pancreatic fistula with loss of bicarbonate rich pancreatic fluid
Metabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance.Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids. [5]
It is used to aid in the differential diagnosis of metabolic acidosis. [2] The term "anion gap" without qualification usually implies serum anion gap. The "urine anion gap" is a different measure, principally used to determine whether the kidneys are capable of appropriately acidifying urine.
Serum glucose levels are measured to document the degree of hypoglycemia. Serum electrolytes calculate the anion gap to determine the presence of metabolic acidosis; typically, patients with glycogen storage disease type 0 (GSD-0) have an anion gap in the reference range and no acidosis. See the Anion Gap calculator. [citation needed]
Toxins, including ifosfamide (more commonly causing pRTA than dRTA), [10] lithium carbonate [11] and amphotericin B. [ 12 ] Toluene causes a non-anion gap metabolic acidosis with hypokalemia and a positive urinary anion gap that looks a lot like distal RTA but there is no hydrogen secretion defect and the acidosis is due to acid production ...
Generally, diseases outlined within the ICD-10 codes E70-E90 within Chapter IV: Endocrine, nutritional and metabolic diseases should be included in this category. The main article for this category is Metabolic disorders .