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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.
English: Causes of high anion-gap metabolic acidosis Mnemonic "CAT MUDPILES": Carbon monoxide, Cyanide, Congenital; heart failure Aminoglycosides; Teophylline, Toluene (Glue-sniffing)
The calculated value of the anion gap should always be adjusted for variations in the serum albumin concentration. [15] For example, in cases of hypoalbuminemia the calculated value of the anion gap should be increased by 2.3 to 2.5 mEq/L per each 1 g/dL decrease in serum albumin concentration (refer to Sample calculations, below).
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
Elevated protein (albumin, globulins) may theoretically increase the anion gap but high levels are not usually encountered clinically. Hypoalbuminaemia, which is frequently encountered clinically, will mask an anion gap. As a rule of thumb, a decrease in serum albumin by 1 G/L will decrease the anion gap by 0.25 mmol/L [citation needed]
Today's NYT Connections puzzle for Sunday, December 15, 2024The New York Times
Urine NH 4 + is difficult to measure directly, but its excretion is usually accompanied by the anion chloride. A negative urine anion gap can be used as evidence of increased NH 4 + excretion. In a metabolic acidosis without a serum anion gap: A positive urine anion gap suggests a low urinary NH 4 + (e.g. renal tubular acidosis).
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