What causes a wide anion gap?

The most common causes of an increased anion gap in acidotic patients are lactic acidosis, diabetic ketoacidosis, uremic acidosis, ethylene glycol intoxication, and laboratory error.

What causes gapped metabolic acidosis?

Causes. The most common causes of high anion gap metabolic acidosis are: ketoacidosis, lactic acidosis, kidney failure, and toxic ingestions. Ketoacidosis can occur as a complication of diabetes mellitus (diabetic ketoacidosis), but can occur due to other disorders, such as chronic alcoholism and malnutrition.

What does a wide anion gap mean?

What does a high anion gap blood test result mean? If your blood test results show a high anion gap, you may have acidosis. This means you may have a higher-than-normal level of acid in your blood (a lower-than-normal blood pH). Acidosis may be a sign of the following: Dehydration.

What does an elevated anion gap indicate in metabolic acidosis?

If the corrected anion gap is greater than 12, this suggests an increased presence of unmeasured anions. Subsequently, the osmolar gap should be calculated to screen for the presence of alcohols, and ethanol, acetaminophen, lactate, salicylic acid, creatinine, and ketones should be measured.

What is the anion gap in DKA?

In mild DKA, anion gap is greater than 10 and in moderate or severe DKA the anion gap is greater than 12. These figures differentiate DKA from HHS where blood glucose is greater than 600 mg/dL but pH is greater than 7.3 and serum bicarbonate greater than 15 mEq/L.

What factors affect anion gap?

The anion gap is affected by changes in unmeasured ions. In uncontrolled diabetes, there is an increase in ketoacids due to metabolism of ketones. Raised levels of acid bind to bicarbonate to form carbon dioxide through the Henderson-Hasselbalch equation resulting in metabolic acidosis.

What causes non anion gap metabolic acidosis?

As shown in Figure 1, a nongap metabolic acidosis can result from the direct loss of sodium bicarbonate from the gastrointestinal tract or the kidney, addition of hydrochloric acid (HCl) or substances that are metabolized to HCl, impairment of net acid excretion, marked urinary excretion of organic acid anions with …

What is the anion gap for DKA?

What labs show metabolic acidosis?

Tests may include:

  • Arterial blood gas.
  • Basic metabolic panel, (a group of blood tests that measure your sodium and potassium levels, kidney function, and other chemicals and functions)
  • Blood ketones.
  • Lactic acid test.
  • Urine ketones.
  • Urine pH.

Why does Kussmaul breathe in DKA?

Here’s an explanation of how diabetic ketoacidosis can lead to Kussmaul breathing: Extra ketones in your body cause acid to build up in your blood. Because of this, your respiratory system is triggered to start breathing faster.