Clinical Evaluation Of Disturbances In Acid-Base Status – Anion Gap

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Chapter: Anatomy, Physiology And Health Education : Acid-Base Balance

Anion gap is an important measure in the clinical evaluation of disturbances in acid-base status. Only few cations and anions are measured during routine clinical investigations. Commonly measured cation is sodium and the unmeasured cations are potassium, calcium and magnesium.


CLINICAL EVALUATION OF DISTURBANCES IN ACID-BASE STATUS – ANION GAP

 

Anion gap is an important measure in the clinical evaluation of disturbances in acid-base status. Only few cations and anions are measured during routine clinical investigations. Commonly measured cation is sodium and the unmeasured cations are potassium, calcium and magnesium. Usually measured anions are chloride and bicarbonate. The unmeasured anions are phosphate, sulfate, proteins in anionic form such as albumin and other organic anions like lactate.

 

Difference between concentrations of unmeasured anions and unmeasured cations is called anion gap.

 

It is calculated as:



 

Normal value of anion gap is 9 to 15 mEq/L. It increases when concentration of unmeasured anion increases and decreases when concentration of unmeasured cations decreases.

 

Anion gap is a useful measure in the differential  diagnosis (diagnosis of the different causes) of acid- base disorders particularly the metabolic acidosis. Variations of anion gap are given in Table 5.5.


 

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