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Abnormal serum anion gap

MedGen UID:
1671081
•Concept ID:
C4732777
•
Finding
HPO: HP:0031961

Definition

Any deviation from the normal value of the serum anion gap, which is calculated from the electrolytes measured in the chemical laboratory, is defined as the sum of serum chloride and bicarbonate concentrations subtracted from the serum sodium concentration. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVAbnormal serum anion gap

Professional guidelines

PubMed

Alcoholic Ketoacidosis: Etiologies, Evaluation, and Management.
Long B, Lentz S, Gottlieb M
J Emerg Med 2021 Dec;61(6):658-665. Epub 2021 Oct 26 doi: 10.1016/j.jemermed.2021.09.007. PMID: 34711442
Renal Tubular Acidosis and Management Strategies: A Narrative Review.
Palmer BF, Kelepouris E, Clegg DJ
Adv Ther 2021 Feb;38(2):949-968. Epub 2020 Dec 26 doi: 10.1007/s12325-020-01587-5. PMID: 33367987Free PMC Article
Metabolic acidosis: pathophysiology, diagnosis and management.
Kraut JA, Madias NE
Nat Rev Nephrol 2010 May;6(5):274-85. Epub 2010 Mar 23 doi: 10.1038/nrneph.2010.33. PMID: 20308999

Recent clinical studies

Etiology

Potassium Metabolism and Management in Patients with CKD.
Yamada S, Inaba M
Nutrients 2021 May 21;13(6) doi: 10.3390/nu13061751. PMID: 34063969Free PMC Article
Diet-induced metabolic acidosis.
Adeva MM, Souto G
Clin Nutr 2011 Aug;30(4):416-21. Epub 2011 Apr 9 doi: 10.1016/j.clnu.2011.03.008. PMID: 21481501
Metabolic acidosis: pathophysiology, diagnosis and management.
Kraut JA, Madias NE
Nat Rev Nephrol 2010 May;6(5):274-85. Epub 2010 Mar 23 doi: 10.1038/nrneph.2010.33. PMID: 20308999
Furosemide and ethacrynic acid: risk factors for the occurrence of serum electrolyte abnormalities and metabolic alkalosis in newborns and infants.
Laudignon N, Ciampi A, Coupal L, Chemtob S, Aranda JV
Acta Paediatr Scand 1989 Jan;78(1):133-5. doi: 10.1111/j.1651-2227.1989.tb10903.x. PMID: 2919515
D-lactate encephalopathy.
Thurn JR, Pierpont GL, Ludvigsen CW, Eckfeldt JH
Am J Med 1985 Dec;79(6):717-21. doi: 10.1016/0002-9343(85)90522-4. PMID: 4073108

Diagnosis

Acute Medication Poisoning.
Vega IL, Griswold MK, Laskey D
Am Fam Physician 2024 Feb;109(2):143-153. PMID: 38393798
Alcoholic Ketoacidosis: Etiologies, Evaluation, and Management.
Long B, Lentz S, Gottlieb M
J Emerg Med 2021 Dec;61(6):658-665. Epub 2021 Oct 26 doi: 10.1016/j.jemermed.2021.09.007. PMID: 34711442
Renal Tubular Acidosis and Management Strategies: A Narrative Review.
Palmer BF, Kelepouris E, Clegg DJ
Adv Ther 2021 Feb;38(2):949-968. Epub 2020 Dec 26 doi: 10.1007/s12325-020-01587-5. PMID: 33367987Free PMC Article
Chloride: the queen of electrolytes?
Berend K, van Hulsteijn LH, Gans RO
Eur J Intern Med 2012 Apr;23(3):203-11. Epub 2011 Dec 21 doi: 10.1016/j.ejim.2011.11.013. PMID: 22385875
Metabolic acidosis: pathophysiology, diagnosis and management.
Kraut JA, Madias NE
Nat Rev Nephrol 2010 May;6(5):274-85. Epub 2010 Mar 23 doi: 10.1038/nrneph.2010.33. PMID: 20308999

Therapy

Pharmacologic Approaches to Electrolyte Abnormalities in Heart Failure.
Grodin JL
Curr Heart Fail Rep 2016 Aug;13(4):181-9. doi: 10.1007/s11897-016-0295-7. PMID: 27278221
Diet-induced metabolic acidosis.
Adeva MM, Souto G
Clin Nutr 2011 Aug;30(4):416-21. Epub 2011 Apr 9 doi: 10.1016/j.clnu.2011.03.008. PMID: 21481501
Metabolic acidosis: pathophysiology, diagnosis and management.
Kraut JA, Madias NE
Nat Rev Nephrol 2010 May;6(5):274-85. Epub 2010 Mar 23 doi: 10.1038/nrneph.2010.33. PMID: 20308999
Furosemide and ethacrynic acid: risk factors for the occurrence of serum electrolyte abnormalities and metabolic alkalosis in newborns and infants.
Laudignon N, Ciampi A, Coupal L, Chemtob S, Aranda JV
Acta Paediatr Scand 1989 Jan;78(1):133-5. doi: 10.1111/j.1651-2227.1989.tb10903.x. PMID: 2919515
D-lactate encephalopathy.
Thurn JR, Pierpont GL, Ludvigsen CW, Eckfeldt JH
Am J Med 1985 Dec;79(6):717-21. doi: 10.1016/0002-9343(85)90522-4. PMID: 4073108

Prognosis

Serum anion gap at admission as a predictor of mortality in the pediatric intensive care unit.
Kim MJ, Kim YH, Sol IS, Kim SY, Kim JD, Kim HY, Kim KW, Sohn MH, Kim KE
Sci Rep 2017 May 3;7(1):1456. doi: 10.1038/s41598-017-01681-9. PMID: 28469150Free PMC Article
Diet-induced metabolic acidosis.
Adeva MM, Souto G
Clin Nutr 2011 Aug;30(4):416-21. Epub 2011 Apr 9 doi: 10.1016/j.clnu.2011.03.008. PMID: 21481501
Hypoalbuminaemia in critically ill children: incidence, prognosis, and influence on the anion gap.
Durward A, Mayer A, Skellett S, Taylor D, Hanna S, Tibby SM, Murdoch IA
Arch Dis Child 2003 May;88(5):419-22. doi: 10.1136/adc.88.5.419. PMID: 12716714Free PMC Article
The role of metabolic acidosis in the pathogenesis of renal osteodystrophy.
Kraut JA
Adv Ren Replace Ther 1995 Jan;2(1):40-51. doi: 10.1016/s1073-4449(12)80070-7. PMID: 7614335
The effects of deep hypothermia and circulatory arrest on systemic metabolic state of infants undergoing corrective open heart surgery: a comparison of two methods.
Kunkel R, Hagl S, Richter JA, Habermeyer P, Sebening F
Thorac Cardiovasc Surg 1979 Jun;27(3):168-77. doi: 10.1055/s-0028-1096239. PMID: 462466

Clinical prediction guides

Renal Tubular Acidosis and Management Strategies: A Narrative Review.
Palmer BF, Kelepouris E, Clegg DJ
Adv Ther 2021 Feb;38(2):949-968. Epub 2020 Dec 26 doi: 10.1007/s12325-020-01587-5. PMID: 33367987Free PMC Article
Diet-induced metabolic acidosis.
Adeva MM, Souto G
Clin Nutr 2011 Aug;30(4):416-21. Epub 2011 Apr 9 doi: 10.1016/j.clnu.2011.03.008. PMID: 21481501
Metabolic acidosis with extreme elevation of anion gap: case report and literature review.
Oster JR, Singer I, Contreras GN, Ahmad HI, Vieira CF
Am J Med Sci 1999 Jan;317(1):38-49. doi: 10.1097/00000441-199901000-00006. PMID: 9892270
Anion gap and hypoalbuminemia.
Figge J, Jabor A, Kazda A, Fencl V
Crit Care Med 1998 Nov;26(11):1807-10. doi: 10.1097/00003246-199811000-00019. PMID: 9824071
The role of metabolic acidosis in the pathogenesis of renal osteodystrophy.
Kraut JA
Adv Ren Replace Ther 1995 Jan;2(1):40-51. doi: 10.1016/s1073-4449(12)80070-7. PMID: 7614335

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