Use of the anion gap in clinical medicine

J. R. Oster, G. O. Perez, Barry J Materson

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

The anion gap (AG) in the serum equals the concentrations of Na - (Cl + HCO3). It is becoming increasingly useful in the interpretation of acid-base disorders and in the diagnosis of other conditions. In an acidemic patient, an elevated AG usually indicates the presence of an organic acidosis, rhabdomyolysis, nonketotic hyperglycemic coma, uremia, or certain intoxications. An increased AG with alkalemia suggests severe alkalosis with hemoconcentration or use of anionic antibiotics (eg, carbenicillin) or salts of organic acids (eg, citrate). An elevated AG with a normal serum pH could be an artifact caused by prolonged exposure of the serum sample to air before processing. A decreased AG with a normal serum pH may indicate hypoalbuminemia, cationic paraproteinemia, halide poisoning, or lithium intoxication. The ΔAG/ΔHCO3 ratio and the urinary AG may also be quite useful in analyzing complex acid-base disorders.

Original languageEnglish
Pages (from-to)229-237
Number of pages9
JournalSouthern Medical Journal
Volume81
Issue number2
StatePublished - Jan 1 1988

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Acid-Base Equilibrium
Clinical Medicine
Serum
Acids
Hyperglycemic Hyperosmolar Nonketotic Coma
Carbenicillin
Hypoalbuminemia
Alkalosis
Paraproteinemias
Rhabdomyolysis
Uremia
Acidosis
Lithium
Citric Acid
Artifacts
Poisoning
Salts
Air
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Oster, J. R., Perez, G. O., & Materson, B. J. (1988). Use of the anion gap in clinical medicine. Southern Medical Journal, 81(2), 229-237.

Use of the anion gap in clinical medicine. / Oster, J. R.; Perez, G. O.; Materson, Barry J.

In: Southern Medical Journal, Vol. 81, No. 2, 01.01.1988, p. 229-237.

Research output: Contribution to journalArticle

Oster, JR, Perez, GO & Materson, BJ 1988, 'Use of the anion gap in clinical medicine', Southern Medical Journal, vol. 81, no. 2, pp. 229-237.
Oster JR, Perez GO, Materson BJ. Use of the anion gap in clinical medicine. Southern Medical Journal. 1988 Jan 1;81(2):229-237.
Oster, J. R. ; Perez, G. O. ; Materson, Barry J. / Use of the anion gap in clinical medicine. In: Southern Medical Journal. 1988 ; Vol. 81, No. 2. pp. 229-237.
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