Using formulate to determine the anion gap is currently a useful tool in the interpretation of acidbase balance. Acidose metabolica normocloremica anion gap aumentado. In the elevated ag treatment of the underlying cause to increase the catabolism of excess anions and regenerate the plasma. Based on this classification, it may establish the most appropriate treatment. Nestecasoclinico,tratasedeumaacidosemetabolica normocloremica,istoe,comaniongapaumentado,devidoao excessodeacidolactico. The anion gap can be used to help identify the cause of metabolic acidosis. However, the second equation is used more often than the first one. The anion gap ag represents the concentration of all the unmeasured anions in the plasma. Anion gap is defined as the difference between measured cations sodium and potassium and anions chloride and bicarbonate in serum. Determining the serum anion gap is commonly used in the differential diagnosis of metabolic acidosis.
Alteraciones acido base, stewart acido base, anion gap. The serum anion gap in the evaluation of acidbase disorders. What are its limitations and can its effectiveness be improved clinical journal of the american society of nephrology internet. The serum anion gap is calculated from the difference between the measured serum cations sodium and anions chloride and bicarbonate. There are 2 formulas you can use in calculating an anion gap. This formula can be used if there is a value for potassium. The anion gap ag or agap is a value calculated from the results of multiple individual medical lab tests. Please define the anion gap and its utility in diagnosis and how it relates to osmolality. Anion gap acidoses have a very different differential diagnosis than non gap acidoses. Depending on the anion gap ag is classified as elevated ag metabolic acidoses or normal ag metabolic acidoses hyperchloraemic acidosis.
A substantial increase in the ag usually indicates the presence of a metabolic acidosis, unless large doses of certain antibiotics or sodium salts of organic acids. Clinical chemistry, immunology and laboratory quality control, 2014. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Review of the diagnostic evaluation of normal anion gap metabolic acidosis. Engelking, in textbook of veterinary physiological chemistry third edition, 2015. Acid base disorders, anion gap, delta gap, stewart acid base, strong ion difference. Anion gap acidoses have a very different differential diagnosis than nongap acidoses. Methanol uremia diabetic ketoacidosis dka or starvation ketosis paraldehyde, phenformin. It may be reported with the results of an electrolyte panel, which is often performed as part of a comprehensive metabolic panel the anion gap is the difference between certain measured cations positively charged ions and the measured anions negatively charged ions in serum, plasma. The anion gap provides an estimation of the unmeasured anions in the plasma and is useful in the setting of arterial blood gas analysis.