Normal anion gap metabolic acidosis: Difference between revisions
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== Differential Diagnosis == |
== Differential Diagnosis == |
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− | * Mild AKI, causing decreased ammonia excretion |
+ | * Mild [[AKI]], causing decreased ammonia excretion |
− | * Lower GI diarrhea |
+ | * Lower GI [[diarrhea]] |
* Fistulas |
* Fistulas |
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** Pancreatic |
** Pancreatic |
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** Ileocutaneous |
** Ileocutaneous |
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− | * Carbonic anhydrase inhibitors |
+ | * [[Carbonic anhydrase inhibitors]] |
− | * Renal tubular acidosis (RTA) |
+ | * [[Renal tubular acidosis]] (RTA) |
** Type 1 (hypokalemic distal) |
** Type 1 (hypokalemic distal) |
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** Type 2 (proximal) |
** Type 2 (proximal) |
Latest revision as of 10:22, 23 October 2021
Differential Diagnosis
- Mild AKI, causing decreased ammonia excretion
- Lower GI diarrhea
- Fistulas
- Pancreatic
- Ileocutaneous
- Carbonic anhydrase inhibitors
- Renal tubular acidosis (RTA)
- Type 1 (hypokalemic distal)
- Type 2 (proximal)
- Type 4 (hyperkalemic distal)
- Ureteral diversion (e.g. ileal loop)
- Iatrogenic
- Dilution acidosis
Investigations
- Serum electrolytes showing normal anion gap metabolic acidosis
- Urine anion gap (U
Na+ UK– UCl)- Difference between unmeasured anions (i.e. NH
4^+^) and unmeasured cations- For most patients, approximates ammonium excretion
- If negative, suggests presence of ammonium (appropriate)
- If kidneys are responding properly, the UAG should be negative
- If defect in acid excretion, UAG should be positive
- Difference between unmeasured anions (i.e. NH
- Urine pH