Dka Anion Gap Range

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Clinical Aspects Of The Anion Gap

The anion gap (AG) is a calculated parameter derived from measured serum/plasma electrolyte concentrations. The clinical value of this calculated parameter is the main focus of this article. Both increased and reduced anion gap have clinical significance, but the deviation from normal that has most clinical significance is increased anion gap associated with metabolic acidosis. This reflects the main clinical utility of the anion gap, which is to help in elucidating disturbances of acid-base balance. The article begins with a discussion of the concept of the anion gap, how it is calculated and issues surrounding the anion gap reference interval. CONCEPT OF THE ANION GAP - ITS DEFINITION AND CALCULATION Blood plasma is an aqueous (water) solution containing a plethora of chemical species including some that have a net electrical charge, the result of dissociation of salts and acids in the aqueous medium. Those that have a net positive charge are called cations and those with a net negative charge are called anions; collectively these electrically charged species are called ions. The law of electrochemical neutrality demands that, in common with all solutions, blood serum/plasma is e Continue reading >>

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Popular Questions

  1. chaiminda

    I understand that the theory is that if I am passing ketones, then my body is burning fat and protein for energy. My doctor says that might mean I'm not getting enough energy, period. Okay, but I am gaining weight and I have as much energy as most 8-months-pregnant women. Baby is a normal size as far as can be determined. Doctor said she doubted that anything I could do at this stage would be a problem for the baby, but said vaguely that it might cause "metabolic issues" or problems with breastfeeding supply for me.
    Are there any scientific studies that actually make it clear what the danger is here?
    (I'm not that interested in "well, my doctor 10 years ago said x" or "my equally vague understanding is..." type replies. I want science.)

  2. peacheater

    Doctors tend to be more scared of ketones than they should be because they're also produced as a result of ketoacidosis, which is a very bad sign in people affected by Type I Diabetes (i.e. not the kind you have, but the kind where insulin is unable to be produced). It is also produced as a result of ketosis, which is when your body is burning fat for fuel, such as on a low-carb diet. This fat could be from your diet or from your body - so I could see how seeing ketones in the urine would be a sign that a person was not getting enough calories if that person was on a regular carbohydrate-heavy diet. Others can weigh in on whether there are pregnancy-specific factors regarding ketones that should be considered, but there are good reasons to be skeptical of doctors who raise alarms regarding ketones, because they've had it drilled into them that ketones = bad, since they most often arise as a reason of ketoacidosis.

  3. instamatic

    PubMed has a lot of studies on this, but most seem vague or 10-20 years old. I found one mouse study that suggests that organ growth is the main concern (most specifically, size of he heart and brain). I read one note about excessive ketones causing similar symptoms to Fetal Alcohol Syndrome. And this:
    "Maternal ketonuria or acetonuria during pregnancy is a concern because it can result in neonatal or childhood neurocognitive dysfunction."
    Here is a more lay-friendly write up that has a bibliography for additional reading.
    However, the vast majority of abstracts in PubMed seem to echo your doctor-- concern abou maternal metabolic issues and breastfeeding. And none of it seems to be studied independent of general gestational diabetes risks. (I don't know enough about fetal organ development to know risks at 8 months pregnant, but hopefully someone with more pregnancy-specific medical knowledge can back up/interpret the studies.)

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