What Causes Normal Anion Gap Acidosis?

Share on facebook

Anion gap usmle - anion gap metabolic acidosis normal anion gap metabolic acidosis

Diarrhoea As A Cause Of Normal Anion Gap Acidosis - Deranged Physiology

Diarrhoea As a Cause of Normal Anion Gap Acidosis Diarrhoea can result in a metabolic acidosis by causing a disproportionate loss of sodium, and thus decreasing the strong ion difference The change in strong ion difference due to intestinal electrolyte losses However, precisely what sort of acid-base disturbance will occur depends entirely on what is being lost, and how. Which is frequently difficult to establish. The content of the gastrointestinal fluid losses is likely to vary from patient to patient, depend strongly on the diet, and be dependent on whether there are any attempts at reclamation (i.e. if the colon is still making an effort to retain electrolytes). Pancreatic secretions, a major source of loss for fluid with a large strong ion difference (which the bowel doesnt get a chance to reclaim) are discussed elsewhere . Similarly, a small bowel fistula with a large output (eg. a high output ileostomy) deserves its own mention . Broad generalizations can be made: the stool transit time is important, as is the volume. If the stool does not spend very long in the colon, reabsorption cannot occur, and electrolyte loss is inevitable. In short, diarrhoea tends to cause a hypona Continue reading >>

Share on facebook

Popular Questions

  1. Redgoat

    Will drinking alcohol (liquor) kick you out of Ketosis?

    I know that most liquors seem to have a ton of sugars in them, but I wasn't sure if drinking that would kick you out of Ketosis. Or if the body metabolized sugar differently.

  2. jd408

    doesnt seem to kick me out, but I dont drink a lot of foofoo drinks.
    Pretty much stick to whiskey. Once in a while have some beer, but I try to stick to whiskey or whiskey and diet coke. Thats a strictly weekend only thing for me though.

  3. pro-tein

    Just read about it yesterday

  4. -> Continue reading
read more
Share on facebook

Inspired by Dr. Myat Soe, MD Internal Medicine Series: Clinical Clerkships Overview and Causes of Non-Anion Gap Metabolic Acidosis Made with help of Blueberry Flashback Recorder

Causes Of Non-anion Gap Metabolic Acidosis

Bicarbonate-rich fluid excreted into the intestines where it is lost (GI loss of HCO3). There is an additional mechanism by which NH4Cl causes a non-AG metabolic acidosis. It is similar to the mechanism by which TPN causes a non-AG metabolic acidosis. Either the NH4Cl or the amino acids in TPN are meatbolized to HCl which causes a transient non-AG metabolic acidosis. The decreased pH and decreased HCO3 stimulate renal tubular reabsorption and generation of HCO3 (secretion of H+). You only end up with a metabolic acidosis if the addition of acid overrides the ability of the renal tubules to secrete H+ and generate NH3+ for excretion in the urine, usually a short-lived process. In prolonged hypercapnia renal tubular cells compensate for a prolonged respiratory alkalosis by decreasing reclaimation and generation of HCO3 (which takes 12-24 hrs for full affect). If the respiratory alkalosis resolves rapidly, reclaimation and generation of HCO3 will return to normal over 1-2 days. During this period you can get a (resolving) non-AG metabolic acidosis. The two main causes you for non-anion gap metabolic acidosis are diarrhea and RTA . Most of the time you can distinguish between these tw Continue reading >>

Share on facebook

Popular Questions

  1. Rcroix

    Hello everyone.
    I have been on the 2:5 for about 6 months and lost about 10kg (over 20lbs) So thank you Dr Mosley!
    A lot of the reviews of the fasting lifesyle seem to suggest that it is just a way to reduce average weekly calories, but I’m sure most of you think there is more going on than simple calorie reduction.
    During the last 10 days I didn’t fast as I was on holiday traveling and found it difficult. Amazingly I did not gain any weight. This has happend on two occasions during the last 6 months.
    I think the fasting days are forcing the body to relearn how to burn fat. I’m a bit confused about the correct scientific terms for this ‘lypolysis’ is I believe the breackdown of fats (into amino acids) and ketosis the burning of
    fat as fuel.
    What ever the terminology it seems like the fasting days teach the body a long forgotten trick of switching from available glucose derived from what we just ate, to reserves stored as fat.
    I suggest that this trait applies to non fast days too, hence the lack of weigh gain during holidays.
    I used to do a bit of distance running and am quite familiar with the concept of ‘hitting the wall’. This is when a runner runs out of glucose and has to switch to fat burning (around the 18mile mark). Often that process is difficult, I have had to sit on the ground for about 3 minutes until my legs felt like they would work again.
    I’m not running now so I can’t try a quick marathon to see if the diet has helped with the switch.
    I welcome your thoughts.
    Good luck
    Perhaps Dr Mosely could weigh in on this with some scientific evidence.

  2. zec4peach

    I love science and this is why I love the 5.2 as it makes so much sense.
    Your body will go into ketosis when fasting for a short time, this is probably why some people get headaches. It will also make you very thirsty and wee a lot as your body tries to flush out the by products from fat metabolism. This is a common symptom of type 1 diabetes but obviously they go into a severe more ketoacidosis due to prolonged lack of insulin and metabolism of glucose and start burning muscle for fuel.
    It’s quite complicated stuff but if you google fasting ketosis there’s loads of interesting info online. Michaels book was lacking in any science stuff which is a shame as I think people are interested.
    I know that athletes or very fit people are more efficient at burning fat as they are used to it so yes I think the 5.2 does reset the metabolism in a similar way.
    I have managed to this this after years of cycling and find I can ride for a few hours on an empty stomach. Always need coffee though !!!

  3. Nika

    Hey Martin!
    I’m also very interested in ketosis. I tried it out a few weeks ago and didn’t eat any carbs for 1,5 week. I lost quite some weight, but felt like I couldn’t sustain it – I started feeling really weak, dizzy, couldn’t walk straight some days and all in all didn’t get the energy boosts some people boast about.
    So now I just cut carbs on my fast days and allow myself fruit and yoghurt on normal days – still prefer not to eat rice, noodles, bread and potatoes though. Sometimes a baked good or chocolate pudding as a treat, but not regularly. I do think this really contributes to my quicker than average weightloss (7kg in 3 weeks, of which most during that first 1,5 week).
    I’ve also started working out fasted. I do this after work before my only meal of the day, so after fasting for over 20 hours. I do HIIT (Insanity), which combines cardio and strength through bodyweight exercises. So far my results have been worse than when I did the program before when eating regularly, but I’m waiting to see how it goes in two weeks when I do my second fit test. My body is most likely also learning how to switch to burning fat efficiently.
    What you said about going on a holiday, this reminded me of the “carb loaders” I know. They basically cut carbs during the week, then they “carbload” on Saturday – eating everything from pizza to ribs to whatever they want. They say that it doesn’t cause them to gain weight, because the body is still in fat burning mode and the glucose from the carbs goes straight to the muscles, giving the muscles the strength to keep working out through the next week. Hence carb ‘loading’. These people are basically in ketosis 3 days a week (it usually takes the body about 3 days to go into full ketosis).
    These are all bodybuilder types though, who do mostly strength training so it doesn’t really sound like a great idea for me. I wanna be lean, not buff.
    Anyway, long post – gonna head over to the next one

  4. -> Continue reading
read more
Share on facebook

High anion gap metabolic acidosis

Renal Fellow Network: Mnemonic For Non-anion Gap Metabolic Acidosis

Mnemonic for NON-Anion Gap Metabolic Acidosis As I've mentioned previously on this blog, the "MUDPALES" mnemonic for anion gap metabolic acidosis is one of the most successful medical mnemonic's of all time. A less successful (and admittedly less useful) mnemonic exists for non-anion gap metabolic acidoses (NAGMA), which I learned as a resident. It's "HARDUP", which stands for the following: H = hyperalimentation (e.g., starting TPN). R = renal tubular acidosis (Type I = distal; Type II = proximal; Type IV = hyporeninemic hypoaldosteronism. U = uretosigmoid fistula (because the colon will waste bicarbonate). P = pancreatic fistula (because of alkali loss--the pancreas secretes a bicarbonate-rich fluid). Practically speaking however, the two main causes you really have to remember for NAGMA are DIARRHEA or RENAL TUBULAR ACIDOSIS, which 90% of the time you can distinguish between based on the history alone. Another way to think about the differential diagnosis of NAGMA is to ask whether or not there is GI LOSS or RENAL LOSS of bicarbonate. If the history does not provide an obvious explanation, one can distinguish between GI versus renal bicarbonate losses by determining the urine a Continue reading >>

Share on facebook

Popular Questions

  1. Desley

    Help! I'm frustrated, I'm into my 2nd week on Induction & I'm still not into Ketosis. I've been keeping my carbs below 20 carbs a day.
    If fact I've been averaging 18. Testing my Urine every 2sd day for the recommended 15 seconds. Anybody got any ideas?

  2. Desley

    Have been reading some old posts (2011) about bringing on Ketosis by upping your fat intake using Coconut Oil. Has anyone got any info on this. What does Atkins think about this?

  3. Helen

    The ketostix are not always accurate. You may be in ketosis when they say you aren't.
    Are you thirsty all the time? Has your hunger gone away? Those are generally the best two ways to recognise that you are in ketosis.
    Saying that, while most people can achieve ketosis in 3-6 days, for some it can take a few weeks, especially if they are insulin resistant.
    Not sure about the Coconut oil (although it is good for you). I have read that it can help in ketogenic diets, but not sure if it will help in the case of Atkins.

  4. -> Continue reading
read more

No more pages to load

Related Articles

  • Normal Anion Gap Metabolic Acidosis Wiki

    Diagnosis Hyperchloremic metabolic acidosis, normo or hypokalemia, decreased titulable acidity in urine, hypercalciuria and/or hipocitraturia. [renaltube.com] Diagnostic methods The disease is characterized by hyperchloremic metabolic acidosis. [orpha.net] This leads to the clinical features of dRTA: [1] Normal anion gap metabolic acidosis /acidemia Hypokalemia Urinary stone formation (related to alkaline urine, hypercalciuria [en.wikipedia.org] ...

    ketosis Apr 24, 2018
  • Normal Anion Gap Metabolic Acidosis

    The anion gap is a tool used to: Confirm that an acidosis is indeed metabolic Narrow down the cause of a metabolic acidosis Monitor the progress of treatment In a metabolic acidosis the anion gap is usually either ‘Normal’ or ‘High’. In rare cases it can be ‘low’, usually due to hypoalbuminaemia. An ABG machine will often give a print out of the anion gap, but it can also be useful to know how it is calculated. In blood, there are man ...

    ketosis May 1, 2018
  • Metabolic Acidosis Anion Gap

    The anion gap is the difference between primary measured cations (sodium Na+ and potassium K+) and the primary measured anions (chloride Cl- and bicarbonate HCO3-) in serum. This test is most commonly performed in patients who present with altered mental status, unknown exposures, acute renal failure, and acute illnesses. [1] See the Anion Gap calculator. The reference range of the anion gap is 3-11 mEq/L The normal value for the serum anion gap ...

    ketosis Jan 4, 2018
  • What Causes Normal Anion Gap Acidosis?

    In renal physiology , normal anion gap acidosis, and less precisely non-anion gap acidosis, is an acidosis that is not accompanied by an abnormally increased anion gap . The most common cause of normal anion gap acidosis is diarrhea with a renal tubular acidosis being a distant second. The differential diagnosis of normal anion gap acidosis is relatively short (when compared to the differential diagnosis of acidosis): Diarrhea : due to a loss of ...

    ketosis Apr 25, 2018
  • Normal Anion Gap Metabolic Acidosis Mnemonic

    Are you studying metabolic acidosis and need to know a mnemonic on how to remember the causes? This article will give you a clever mnemonic and simplify the signs and symptoms and nursing interventions on how to remember metabolic acidosis for nursing lecture exams and NCLEX. In addition, you will learn how to differentiate metabolic acidosis from metabolic alkalosis. Don’t forget to take the metabolic acidosis and metabolic alkalosis quiz. Thi ...

    ketosis Apr 27, 2018
  • Icd 10 Code For Anion Gap Metabolic Acidosis

    The prevalence rate is probably about 1 in 100,000 live births worldwide. A high prevalence rate is noted in certain countries like Saudi Arabia. Propionic acidemia can present in one of the following forms: severe neonatal onset, intermittent late onset or a chronic progressive form. In the severe neonatal onset form, the affected infants present with symptoms of metabolic intoxication (poor feeding, vomiting, altered sensorium) and pancytopeni ...

    ketosis Mar 29, 2018

Popular Articles

More in ketosis