138:: due to a loss of bicarbonate. This is compensated by an increase in chloride concentration, thus leading to a normal anion gap, or hyperchloremic, metabolic acidosis. The pathophysiology of increased chloride concentration is the following: fluid secreted into the gut lumen contains higher amounts of Na than Cl; large losses of these fluids, particularly if volume is replaced with fluids containing equal amounts of Na and Cl, results in a decrease in the plasma Na concentration relative to the Clconcentration. This scenario can be avoided if formulations such as lactated Ringer’s solution are used instead of normal saline to replace GI losses.
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Hyperparathyroidism – can cause hyperchloremia and increase renal bicarbonate loss, which may result in a normal anion gap metabolic acidosis. Patients with hyperparathyroidism may have a lower than normal pH, slightly decreased PaCO2 due to respiratory compensation, a decreased bicarbonate level,
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As opposed to high anion gap acidosis (which involves increased organic acid production), normal anion gap acidosis involves either increased production/administration of
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of normal anion gap acidosis is relatively short (when compared to the differential diagnosis of
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Coe FL (August 1974). "Magnitude of metabolic acidosis in primary hyperparathyroidism".
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The most common cause of normal anion gap acidosis is
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71:accompanied by an abnormally increased
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296:10.1001/archinte.1974.00320200072008
547:Mixed disorder of acid-base balance
115:administration, often from normal
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206:High anion gap metabolic acidosis
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126:carbonic anhydrase inhibitors
192:) or increased excretion of
159:Pancreaticoduodenal fistula
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144:– an abnormal connection (
254:Textbook of Critical Care
61:Normal anion gap acidosis
22:Normal anion gap acidosis
86:being a distant second.
190:hyperchloremic acidosis
180:and a normal anion gap.
455:Alcoholic ketoacidosis
154:gastrointestinal tract
142:Ureteroenteric fistula
131:Renal tubular acidosis
96:differential diagnosis
90:Differential diagnosis
84:renal tubular acidosis
30:Non-anion gap acidosis
552:Acid–base homeostasis
524:Contraction alkalosis
450:Diabetic ketoacidosis
415:Acid–base disorders
249:Jean-Louis Vincent
176:High ostomy output
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284:Arch. Intern. Med
107:Hyperalimentation
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232:. Retrieved
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531:Respiratory
497:Respiratory
489:Respiratory
194:bicarbonate
27:Other names
573:Nephrology
367:DiseasesDB
268:143771367X
234:2008-12-04
212:References
124:and other
45:nephrology
519:Metabolic
511:Alkalosis
432:Metabolic
73:anion gap
36:Specialty
567:Category
423:Acidosis
259:Elsevier
200:See also
186:chloride
167:duodenum
163:pancreas
152:and the
136:Diarrhea
113:Chloride
100:acidosis
80:diarrhea
67:that is
65:acidosis
304:4843192
146:fistula
82:with a
460:Lactic
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150:ureter
117:saline
63:is an
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540:Other
372:29144
361:276.2
346:E87.2
356:9-CM
300:PMID
263:ISBN
165:and
94:The
352:ICD
337:ICD
292:doi
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69:not
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Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
