Recurrent Anion Gap Metabolic Acidosis

Sajan, Abin; Horowitz, Judah; Murakami, Noriyuki; McFarlane, Isabel M.

doi:10.12691/ajmcr-7-9-5

Cited by 6 publications

(4 citation statements)

References 11 publications

(10 reference statements)

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“…An exploratory subgroup analysis of the relationship between ACAG and 30-d mortality in asthmatic patients was conducted. The subgroups involved included different gender, age, acute phase, and coexisting conditions such as diabetic ketoacidosis and renal insufficiency, which are known to elevate AG levels 16 . The analysis revealed a significant correlation between ACAG and 30-d mortality in all subgroups ( p < 0.001), and the interaction analysis showed no statistically significant differences among the subgroups (p > 0.05), indicating consistency of results across the different groups.…”

Section: Resultsmentioning

confidence: 99%

The relationship between albumin corrected anion gap levels and mortality in patients with asthma in the ICU

Wang,

Teng,

Han

et al. 2023

Sci Rep

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Although previous studies have suggested that albumin-corrected anion gap (ACAG) may be a predictor of mortality in critically ill patients in intensive care unit (ICU), its utility in the context of asthma has not been definitively established. In this study, baseline data, albumin concentration, anion gap (AG) and 30-d mortality data were retrieved from the Medical Information Mart for Intensive Care IV database (MIMIC-IV) for patients with asthma in the intensive care unit. Receiver operating characteristic (ROC) curves were constructed to analyze the predictive ability of ACAG and AG. The risk of 30-day mortality among patients with ACAG and asthma was analyzed using a restricted cubic spline (RCS) plot. Decision curve analysis (DCA) was used to evaluate the clinical usefulness of ACAG as a prognostic factor for 30-day mortality. Subsequently, subgroup analysis was conducted to explore potential variations in the relationship between ACAG and 30-day mortality based on factors such as sex, age, whether the asthma was acute, and other co-morbidities. Our study reveals that ACAG is a significant independent predictor of 30-day mortality in asthmatic patients receiving intensive care. The area under the AUC curve for ACAG was found to be 0.703, which is higher than that of AG, indicating that ACAG has a better predictive ability for 30-day mortality in this population. Furthermore, higher levels of ACAG were found to be associated with increased risk of 30-day mortality in asthmatic patients. In addition, decision curve analysis (DCA) demonstrated that the net benefit of ACAG was greater than that of AG. These findings suggest that ACAG may be a valuable prognostic factor for predicting 30-day mortality in asthmatic patients in the ICU. Our study provides evidence that ACAG is associated with an increased risk of 30-d mortality and has better predictive value in patients with combined asthma who are admitted to the ICU than AG.

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Section: Resultsmentioning

confidence: 99%

The relationship between albumin corrected anion gap levels and mortality in patients with asthma in the ICU

Wang,

Teng,

Han

et al. 2023

Sci Rep

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“…Metabolic acidosis is one of the most common complications of patients hospitalized in ICU, and high AG metabolic acidosis is one subcategory of metabolic acidosis [ 26 , 27 ]. In a prospective study [ 28 ], plasma AG was measured in 500 critically ill patients, and the authors concluded that an elevated AG level on ICU admission was associated with higher mortality and longer length of stay in the ICU.…”

Section: Discussionmentioning

confidence: 99%

The association between albumin corrected anion gap and ICU mortality in acute kidney injury patients requiring continuous renal replacement therapy

2022

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The relationship between albumin corrected anion gap (ACAG) and mortality in acute kidney injury (AKI) patients who received continuous renal replacement therapy (CRRT) has not been investigated in any previous studies. This study aimed to investigate the relationship between ACAG at CRRT initiation and all-cause mortality among these patients in the intensive care unit (ICU). Patients diagnosed with AKI and treated with CRRT in the ICU from the Medical Information Mart for Intensive Care-IV version 1.0 (MIMIC IV) database and Huzhou Central Hospital were retrospectively enrolled. Participants were divided into two groups: the normal ACAG group (12-20 mmol/L) and high ACAG group (> 20 mmol/L). The Kaplan-Meier method and log-rank test were used to compare the survival rate between the two groups. Restricted cubic spine (RCS) and Cox proportional-hazards models were utilized to analyze the relationship between ACAG at CRRT initiation and ICU all-cause mortality of these patients. A total of 708 patients met the inclusion criteria in the study. The all-cause mortality of these patients during ICU hospitalization was 41.95%. Patients in the high ACAG group exhibited significantly higher ICU all-cause mortality rate than patients in the normal ACAG group (all P < 0.001). The Kaplan-Meier survival curves showed that the normal ACAG group had a higher ICU cumulative survival rate than the high ACAG group (log-rank test, χ 1 2 = 13.620, χ 2 2 = 12.460, both P < 0.001). In the multivariate COX regression analyses, patients with higher ACAG (> 20 mmol/L) levels at the time of CRRT initiation in the MIMIC IV database and Huzhou Central Hospital were significantly correlated with ICU all-cause mortality after adjusting multiple potential confounding factors with hazard ratios of 2.852 (95% CI 1.718-4.734) and 2.637(95% CI 1.584-4.389), respectively. In critically AKI patients who undergo CRRT, higher ACAG (> 20 mmol/L) level at the initiation of CRRT was significantly correlated with ICU all-cause mortality. Therefore, clinicians should pay more attention to those patients with a higher ACAG value.

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“…There is a need for extracting energy from AN source. There is a shift in AE⇄AN energy balance, and then a shift in the acid-base balance, resulting in body acidosis [ 49 , 50 , 51 ]. As a result, the picture of PA related to functioning in a medium without oxygen is traced.…”

Section: Discussion On the Hypothesis Verificationmentioning

confidence: 99%

Alteration of Relative Rates of Biodegradation and Regeneration of Cervical Spine Cartilage through the Restoration of Arterial Blood Flow Access to Rhomboid Fossa: A Hypothesis

Zhukov¹,

Vetcher

Gasparuan³

et al. 2021

Polymers

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We found the logical way to prove the existence of the mechanism that maintains the rates of biodegradation and regeneration of cervical spine cartilage. We demonstrate, that after we restore access to arterial blood flow through cervical vertebral arteries to rhomboid fossa it causes the prevalence of regeneration over biodegradation. This is in the frames of consideration of the human body as a dissipative structure. Then the recovery of the body should be considered as a reduction of the relative rates of decay below the regeneration ones. Then the recovery of cervical spine cartilage through redirecting of inner dissipative flow depends on the information about oxygen availability that is provided from oxygen detectors in the rhomboid fossa to the cerebellum. Our proposed approach explains already collected data, which satisfies all the scientific requirements. This allows us to draw conclusions that permit reconsidering the way of dealing with multiple chronic diseases.

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Recurrent Anion Gap Metabolic Acidosis

Cited by 6 publications

References 11 publications

The relationship between albumin corrected anion gap levels and mortality in patients with asthma in the ICU

The relationship between albumin corrected anion gap levels and mortality in patients with asthma in the ICU

The association between albumin corrected anion gap and ICU mortality in acute kidney injury patients requiring continuous renal replacement therapy

Alteration of Relative Rates of Biodegradation and Regeneration of Cervical Spine Cartilage through the Restoration of Arterial Blood Flow Access to Rhomboid Fossa: A Hypothesis

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