A New Range for the Anion Gap
Authors: S. A. Sadjadi
Journal: Annals of Internal Medicine (1995)

Letters15 November 1995A New Range for the Anion GapS. A. Sadjadi, MDS. A. Sadjadi, MDVeterans Administration Medical Center; Hampton, VA 23667Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-10-199511150-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The anion gap, the difference between routinely measured anions and cations of the serum, or NA+ − (Cl− + HCO3−), is a useful tool for deciphering simple and mixed acid-base disorders. When low, the anion gap can be used to indicate the presence of occult cancer or drug poisoning. The traditional normal value for the anion gap has been 12 ± 4 mEq/L (normal range, 8 to 16 mEq/L), values that textbooks continue to reiterate [1, 2]. However, as noted by Winter and colleagues [3] and others [4], the range for the anion gap is much narrower ...References1. Bushinsky D. Metabolic acidosis. In: Jacobson H, Striker GE, Klahr S. eds. Principles and Practice of Nephrology. St. Louis, MO: Mosby; 1995:924-32. Google Scholar2. Levinsky NG. Acidosis and alkalosis. In: Harrison's Principles of Internal Medicine. 13th ed. New York: McGraw-Hill; 1994:253-62. Google Scholar3. Winter SD, Pearson R, Gabow PG, Schultz AL, Lepoff RB. The fall of the serum anion gap. Arch Intern Med. 1990; 150:311-3. Google Scholar4. Sadjadi SA, Fagan T. Lower values and a new range for anion gap in the diagnosis of acid base disorders. J Am Soc Nephrol. 1993:299. Google Scholar5. Iberti TJ, Leibowitz AB, Papadakos PJ, Fischer EP. Low sensitivity of the anion gap as a screen to detect hyperlactatemia in critically ill patients. Crit Care Med. 1990; 18:275-8. Google Scholar Author, Article, and Disclosure InformationAuthors: S. A. Sadjadi, MDAffiliations: Veterans Administration Medical Center; Hampton, VA 23667 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySerum anion gap revisited: a verified reference interval for contemporary useDiabetic Ketoacidosis and Hyperosmolar Hyperglycemic SyndromeAcid–Base PhysiologyAnion gap reference intervals show instrument dependence and weak correlation with albumin levelsAcid–Base Balance in the Poisoned PatientHyperphosphatemia, a Cause of High Anion Gap Metabolic Acidosis: Report of a Case and Review of the LiteratureThe evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and managementAcid–Base Balance in the Poisoned PatientAcid–Base Balance in the Poisoned PatientAcid–Base PhysiologyDiabetic Ketoacidosis and Hyperosmolar Hyperglycemic SyndromeAcid-Base DisordersAnion Gap and Strong Ion GapCase Studies: Acid-Base ProblemsCetoacidose diabética em adultos: atualização de uma complicação antigaDisorders of acid-base balanceMetabolic Acidosis With Extreme Elevation of Anion Gap: Case Report and Literature ReviewMetabolic Acidosis With Extreme Elevation of Anion Gap: Case Report and Literature ReviewBiochemical and biophysical principles of hydrogen ion regulationMaking Strong Ion Difference the "Euro" for Bedside Acid-Base Analysis 15 November 1995Volume 123, Issue 10Page: 807KeywordsAnionsChloridesCreatinineDrugsLactatesLactic acidosisPotassiumRenal failureSerum albuminSodium ePublished: 15 August 2000 Issue Published: 15 November 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...