Anion gap

The anion gap is the difference between unestimated anions (e.g. phosphate, ketones, lactate) and cations.

In metabolic acidosis an increased anion gap occurs with renal failure, ingestion of acid, ketoacidosis and hyperlactataemia, whereas a normal anion gap (usually associated with hyperchloraemia) is found with decreased acid excretion (e.g. Addison's disease, renal tubular acidosis) and loss of base (e.g. diarrhoea, pancreatic/biliary fistula, acetazolamide, ureterosigmoidostomy).

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