Info

Metabolic acidosis

Normal anion gap High anion gap

(hyperchloremic) (normochloremic)

Na+ 140

A-10

Cl-126

Na+ 140

Cl-106

Causes Renal acidification defects Proximal renal tubular acidosis Classic distal tubular acidosis Hyperkalemic distal tubular acidosis Early renal failure Gastrointestinal loss of bicarbonate Diarrhea

Small bowel losses Ureteral diversions Anion exchange resins Ingestion of CaCl2 Acid infusion HCl

Arginine HCl Lysine HCl

Causes Endogenous acid load Ketoacidosis Diabetes mellitus Alcoholism Starvation Uremia

Lactic acidosis Exogenous toxins Osmolar gap present Methanol Ethylene glycol Osmolar gap absent Salicylates Paraldehyde

HCO3- 4

Lactic acidosis

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