Simple and Mixed Acid-Base Disorders

Narins, Robert G.; Emmett, Michael

doi:10.1097/00005792-198005000-00001

Cited by 272 publications

(104 citation statements)

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“…If the decline in plasma [HCO3] in a patient with keto acidosis is less than the increment in anion gap, one should suspect coexisting metabolic alkalosis [45,46], as when vomiting or alkali ingestion offsets the effect of ketogenesis. Other possible causes of this finding include an exchange of extracellular H+ for intracellular sodium and potassium ions, and hemoconcentration (of serum proteins) [40].…”

Section: Ketoacidosis and The Anion Gapmentioning

confidence: 99%

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Acid-Base Aspects of Ketoacidosis

Oster

Epstein²

1984

Am J Nephrol

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Section: Ketoacidosis and The Anion Gapmentioning

confidence: 99%

“…The presence of large amounts of urinary or serum ketones together with a substantial increase in the anion gap sig nifies the presence of ketoacidosis, but not necessarily acidemia [46]. Administration of bicarbonate to a ketotic patient with alkalemia is obviously contraindicated.…”

Section: Diabetic Ketoalkalosismentioning

confidence: 99%

Acid-Base Aspects of Ketoacidosis

Oster

Epstein²

1984

Am J Nephrol

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“…A nongap metabolic acidosis is characterized by a serum anion gap that is unchanged from baseline, or a decrease in serum [HCO 3 2 ] that exceeds the rise in the anion gap (5,6). Whenever possible, the baseline anion gap of the patient should be used rather than the average normal value specific to a particular clinical laboratory (6) and the anion gap should be corrected for the effect of a change in serum albumin concentration (7).…”

Section: Recognition and Pathogenesis Of The Hyperchloremia And Hypobmentioning

confidence: 99%

Differential Diagnosis of Nongap Metabolic Acidosis

Kraut

Madias

2012

Clinical Journal of the American Society of Nephrology

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SummaryNongap metabolic acidosis is a common form of both acute and chronic metabolic acidosis. Because derangements in renal acid-base regulation are a common cause of nongap metabolic acidosis, studies to evaluate renal acidification often serve as the mainstay of differential diagnosis. However, in many cases, information obtained from the history and physical examination, evaluation of the electrolyte pattern (to determine if a nongap acidosis alone or a combined nongap and high anion gap metabolic acidosis is present), and examination of the serum potassium concentration (to characterize the disorder as hyperkalemic or hypokalemic in nature) is sufficient to make a presumptive diagnosis without more sophisticated studies. If this information proves insufficient, indirect estimates or direct measurement of urinary NH 4 + concentration, measurement of urine pH, and assessment of urinary HCO 3 2 excretion can help in establishing the diagnosis. This review summarizes current information concerning the pathophysiology of this electrolyte pattern and the value and limitations of all of the diagnostic studies available. It also provides a systematic and cost-effective approach to the differential diagnosis of nongap metabolic acidosis.

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“…In latter stages of renal failure, there is retention of these unmeasured anions and high anion gap metabolic acidosis develops (Kraut & Kurtz, 2005;Narins & Emmett, 1980).…”

Section: Chronic and Acute Renal Failurementioning

confidence: 99%

Pathophysiological Approach to Acid Base Disorders

Ali¹

2012

Topics in Renal Biopsy and Pathology

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Simple and Mixed Acid-Base Disorders

Cited by 272 publications

References 0 publications

Acid-Base Aspects of Ketoacidosis

Acid-Base Aspects of Ketoacidosis

Differential Diagnosis of Nongap Metabolic Acidosis

Pathophysiological Approach to Acid Base Disorders

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