Advertisement

High Anion Gap Metabolic Acidosis

  • Alluru S. ReddiEmail author
Chapter

Abstract

In the previous chapter, we presented various causes of high anion gap (AG) metabolic acidosis. For discussion purpose, these causes can be conveniently divided into the following categories: acidosis due to kidney injury; acidosis due to accumulation of organic acids; and acidosis due to toxins. Metabolic acidosis affects almost all organ systems; however, the following are the most important clinical manifestations: cardiovascular, neurologic, and respiratory.

Keywords

L-Lactic acidosis D-Lactic acidosis Diabetic ketoacidosis Alcohol ketoacidosis Starvation ketoacidosis Clinical manifestations of metabolic acidosis 

References

  1. 1.
    Barceloux DG, Krenzelok EP, Olson K, et al. American academy of clinical toxicology practice guidelines on the treatment of ethylene glycol poisoning. J Toxicol Clin Toxicol. 1999;37:537–60.PubMedCrossRefGoogle Scholar

Suggested Reading

  1. 1.
    Cerdá J, Tolwani AJ, Warnock DG. Critical care nephrology: management of acid-base disorders with CRRT. Kidney Int. 2012;82:9–18.PubMedCrossRefGoogle Scholar
  2. 8.
    Fall PJ, Szerlip HM. Lactic acidosis: from sour milk to septic shock. J Intensive Care Med. 2005;20:255–71.PubMedCrossRefGoogle Scholar
  3. 6.
    Fenves AZ, Kirkpatrick HM III, Patel VV, et al. Increased anion gap metabolic acidosis as a result of 5-oxoproline (pyroglutamic acid): a role for acetaminophen. Clin J Am Soc Nephrol. 2006;1:441–7.PubMedCrossRefGoogle Scholar
  4. 2.
    Kraut JA, Madias NE. Treatment of acute metabolic acidosis: a pathophysiologic approach. Nat Rev Nephrol. 2012;8:589–601.PubMedCrossRefGoogle Scholar
  5. 3.
    Kraut JA, Xing SX. Approach to the evaluation of a patient with an increased serum osmolal gap and high-anion gap metabolic acidosis. Am J Kidney Dis. 2011;58:480–4.PubMedCrossRefGoogle Scholar
  6. 4.
    Kraut JA, Madias NE. Metabolic acidosis: pathophysiology, diagnosis and management. Nat Rev Nephrol. 2010;6:274–85.PubMedCrossRefGoogle Scholar
  7. 10.
    Hood Vl. Lactic acidosis. In: Jennari FJ, Adrogué HJ, Galla JH, Madias NE, editors. Acid-base disorders and their treatment. Boca Raton: Taylor & Francis; 2005. pp 351–82.CrossRefGoogle Scholar
  8. 11.
    Laski ME, Wesson DE. Lactic acidosis. In: Acid-base and electrolyte disorders. A companion to Brenner & Rector’s the Kidney. Philadelphia: Saunders; 2002. pp 83–107.Google Scholar
  9. 5.
    Velez JC, Janech MG. A case of lactic acidosis induced by linezolid. Nat Rev Nephrol. 2010;6:236–40.PubMedCrossRefGoogle Scholar
  10. 7.
    Kang KP, Lee S, Kang SK. D-Lactic acidosis in humans: review of update. Electrolyte Blood Press. 2006;4:53–6.CrossRefGoogle Scholar
  11. 9.
    Oh MS, Halperin ML. Toxin-induced metabolic acidosis. In: Jennari FJ, Adrogué HJ, Galla JH, Madias NE, editors. Acid-base disorders and their treatment. Boca Raton: Taylor & Francis; 2005, pp 383–415.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Medicine Division of Nephrology and HypertensionRutgers New Jersey Medical SchoolNewarkUSA

Personalised recommendations