What Is An Anion Gap Metabolic Acidosis?

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Dr. G explains how to calculate an anion gap and then interpret how that relates to changes in bicarb via the delta-delta.

Anion Gap - An Overview | Sciencedirect Topics

The anion gap (AG) is the difference between the sum of the commonly measured cations and the sum of the commonly measured anions in serum, calculated as follows:AG=([Na+]+[K+])([Cl]+[HCO3]). Larry R. Engelking, in Textbook of Veterinary Physiological Chemistry (Third Edition) , 2015 The plasma anion gap is normally accounted for by proteins and other organic acids in the anionic form, phosphates, and sulfate. Hypoproteinemia causes a decrease in the anion gap. Normochloremic metabolic acidosis is usually associated with an increase in the anion gap. The plasma anion gap may not change in hyperchloremic metabolic acidosis. The urinary anion gap can be used to estimate the urine NH4+ concentration. The urinary anion gap, which is usually positive, may be negative in diarrheal disease. The urinary anion gap may not provide meaningful information when the urinary bicarbonate concentration in increased, or when ketone bodies appear in urine. Non-hypoproteinemic metabolic alkalosis is associated with an increase in the anion gap. In Clinical Veterinary Advisor: The Horse , 2012 Because total cations equal total anions in the blood, the anion gap indirectly represents the difference bet Continue reading >>

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  1. Emacfarland

    I cooked some nice fatty sage pork breakfast sausage for Christmas breakfast from the meat counter at Whole Foods. I ate some and thought it tasted a bit sweet, so I looked at the label and realized brown sugar was one of the ingredients! I wouldn't have thought to look at the ingredients since I wouldn't think regular pork breakfast sausage would include sugar. I can't find any nutritional info regarding how many carbs it contained. If sugar is listed as an ingredient is this going to impact my ketones? I ate maybe 6 oz because it was really nice and fatty!

  2. Pilotbob

    Basically sugar is a carb. So 1g of sugar is 1g of carbs. Did it not list carbs in the nutritional information?

  3. larry


    If sugar is listed as an ingredient is this going to impact my ketones? I ate maybe 6 oz because it was really nice and
    Just like any other carb, you have to count what you eat. You may be able to look the product up on the Whole Foods website (if they're the manufacturer) to get exact information, or even call them.

    It's a little suspicious that you were able to taste it. Except for that circumstance I would guess the sugar is pretty minimal.

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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

Treatment Of Acute Non-anion Gap Metabolic Acidosis

Treatment of acute non-anion gap metabolic acidosis Medical and Research Services VHAGLA Healthcare System, Division of Nephrology, VHAGLA Healthcare System Correspondence to: Jeffrey A. Kraut; E-mail: [email protected] Search for other works by this author on: Clinical Kidney Journal, Volume 8, Issue 1, 1 February 2015, Pages 9399, Jeffrey A. Kraut, Ira Kurtz; Treatment of acute non-anion gap metabolic acidosis, Clinical Kidney Journal, Volume 8, Issue 1, 1 February 2015, Pages 9399, Acute non-anion gap metabolic acidosis, also termed hyperchloremic acidosis, is frequently detected in seriously ill patients. The most common mechanisms leading to this acidbase disorder include loss of large quantities of base secondary to diarrhea and administration of large quantities of chloride-containing solutions in the treatment of hypovolemia and various shock states. The resultant acidic milieu can cause cellular dysfunction and contribute to poor clinical outcomes. The associated change in the chloride concentration in the distal tubule lumen might also play a role in reducing the glomerular filtration rate. Administration of base is often recommended for the treatment of acute non-anion ga Continue reading >>

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  1. AngelicLyna

    I've been using the ReliOn ketone test strips since I started Atkins to test for ketosis and my question is, where do I want my ketone level to be on the Atkins diet? My reading is usally "small" to "moderate", should it be higher or is that where I want my ketone level to be?
    Thanks in advance,

  2. JerseyGyrl

    I lost over 100 lbs on Atkins and the ketostix never changed color so, I may not be the ideal person to answer your question
    There are a lot of factors that affect the strips....how much water you drink, how much fat you're eating etc.
    I personally wouldn't be too concerned about the level they are showing as long as you are losing weight and obviously you are! Good job! Keep up the good work!

  3. winning the war

    Too many ketones can put you into ketoacidosis, which can be deadly. While this is usually seen with diabetics, I would be careful and ask your doctor what your level should be. I would guess (and it's only a guess) that anything higher than moderate is or can be dangerous.

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A lecture on the differential diagnosis of a normal anion gap metabolic acidosis, focusing on renal tubular acidosis, but also covering diarrhea, saline infusion, hyperkalemia, kidney failure, and ureteral diversion

Review Of The Diagnostic Evaluation Of Normal Anion Gap Metabolic Acidosis

Acid-Base, Electrolyte and Fluid Alterations: Review Review of the Diagnostic Evaluation of Normal Anion Gap Metabolic Acidosis I have read the Karger Terms and Conditions and agree. I have read the Karger Terms and Conditions and agree. Buy a Karger Article Bundle (KAB) and profit from a discount! If you would like to redeem your KAB credit, please log in . Save over 20% compared to the individual article price. Buy Cloud Access for unlimited viewing via different devices Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use * The final prices may differ from the prices shown due to specifics of VAT rules. For additional information: Background: Normal anion gap metabolic acidosis is a common but often misdiagnosed clinical condition associated with diarrhea and renal tubular acidosis (RTA). Early identification of RTA remains challenging for inexperienced physicians, and diagnosis and treatment are often delayed. Summary: The presence of RTA should be considered in any patient with a high chloride level when the CL-/Na+ ratio is above 0.79, if the Continue reading >>

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  1. ElGranTigre

    I've got INSANE keto breath (been on keto for 100 days). I love it but my kids gag around me. Not good. I've come to the well here at Reddit for every part of my keto voyage but not here. On this topic, search the threads, you see a variety of very authoritative people assert the following things, which just can't be the case simultaneously:
    Ketobreath (KB) can be solved by brushing and flossing; and
    Brushing and flossing are irrelevant because it's a fire in your gut
    Drinking lots of water helps with it (or, makes no difference)
    Electrolytes, electrolytes, electrolytes, People! Read the damn FAQ! (Perpaps a safe answer for 99% of questions)
    Cause of KB is too little fat
    Cause of KB is too much protein
    Cause of KB is too little protein
    Just use Altoids, the small sugar free ones (personal experience: if you're in full KB Beast Mode, that tin will go down QUICK).
    KB will go away after 6 months
    KB will never ever go away.
    You have KB because your mama didn't hug you enough as a child (OK that one's just made up).
    Basically, if I read Redditors right, the cause of ketobreath is doing something wrong while on keto. Fix whatever you were doing wrong and that'll fix ketobreath. And then there's the occasional recluse who speculates that they don't even know if they have ketobreath because there's basically nobody in their lives to tell them that they do (for you all: YES YOU HAVE KETO BREATH).
    Anyway this whole state of affairs just doesn't seem right. What really is keto breath? What causes it and what fixes it?
    I need some help from my brothers & sisters here. I can't guzzle another obscure brand of mouthwash that some Redditor swears works. I can't recalculate my macros every time and try to attribute it to one thing or another because doing that, itself, requires that I breath on people and say "do you smell me?"
    And that's insane. Desperate times.
    Losing my mind over this one. :-(

  2. robxxx

    My keto breath is masked by my coffee breath.

  3. OllieBrown

    Been in keto for a month and no keto breath. Maybe it varies from person to person? It would suck, however, to lose a bunch of weight and then repel a new lover due to bad breath.

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