METABOLIC ACIDOSIS: Elevated Anion Gap

METABOLIC ACIDOSIS: Elevated Anion Gap Metabolic AcidosisNeed to correct anion gap for albumin: For every drop of 10 for albumin (from 40) add 2.5 to the anion gap Normal Anion Gap (<=14)(loss of HCO3)Elevated Anion Gap (>14)(Gain of H+)Excess acid addition Decreased NH4 production and anion secretionLactic acidosis Ketosis Toxic alcohol ingestion AKI/CKD Elevated serum creatinine Diabetic ketoacidosis Starvation/alcoholic ketosis Salicylate poisoning Ethylene/Propylene glycol Methanol Shock Drugs Inborn errors Elevated osmolar gap Positive serum ketones Elevated serum lactatePositive serum salicylate level Other ingestion Paraldehyde, Iron, Isoniazid, Toluene, Cyanide