Non anion gap acidosis - Revision history

Danbot: Strip excess bold

2026-03-22T09:36:26Z

Strip excess bold

← Older revision		Revision as of 09:36, 22 March 2026
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	*Non-anion gap metabolic acidosis (NAGMA) = metabolic acidosis with a normal anion gap (typically 8-12)		*Non-anion gap metabolic acidosis (NAGMA) = metabolic acidosis with a normal anion gap (typically 8-12)
	*Caused by loss of bicarbonate (GI or renal) or addition of chloride (hyperchloremic acidosis)		*Caused by loss of bicarbonate (GI or renal) or addition of chloride (hyperchloremic acidosis)
	*Mnemonic: ~~'''~~HARDUPS~~'''~~ — Hyperalimentation, Acetazolamide, RTA, Diarrhea, Ureteral diversion, Pancreatic fistula, Saline infusion		*Mnemonic: HARDUPS — Hyperalimentation, Acetazolamide, RTA, Diarrhea, Ureteral diversion, Pancreatic fistula, Saline infusion
	*Distinguish from anion gap metabolic acidosis (AGMA) which has a different differential		*Distinguish from anion gap metabolic acidosis (AGMA) which has a different differential

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	===GI Bicarbonate Loss===		===GI Bicarbonate Loss===
	*~~'''~~Diarrhea~~'''~~ (most common cause)		*Diarrhea (most common cause)
	*Pancreatic fistula or drainage		*Pancreatic fistula or drainage
	*Ureteral diversion (ileal conduit, ureterosigmoidostomy)		*Ureteral diversion (ileal conduit, ureterosigmoidostomy)
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	===Renal Bicarbonate Loss / Impaired Acid Excretion===		===Renal Bicarbonate Loss / Impaired Acid Excretion===
	*~~'''~~Renal tubular acidosis (RTA)~~'''~~		*Renal tubular acidosis (RTA)
	**Type 1 (distal): impaired H+ secretion, urine pH >5.5, hypokalemia		**Type 1 (distal): impaired H+ secretion, urine pH >5.5, hypokalemia
	**Type 2 (proximal): impaired HCO3 reabsorption, urine pH <5.5 after bicarb depleted		**Type 2 (proximal): impaired HCO3 reabsorption, urine pH <5.5 after bicarb depleted
	**Type 4 (hypoaldosteronism): ~~'''~~hyperkalemia~~'''~~, urine pH <5.5		**Type 4 (hypoaldosteronism): hyperkalemia, urine pH <5.5
	*Early renal failure		*Early renal failure
	*Carbonic anhydrase inhibitors ([[acetazolamide]], [[topiramate]])		*Carbonic anhydrase inhibitors ([[acetazolamide]], [[topiramate]])

	===Iatrogenic===		===Iatrogenic===
	*~~'''~~Excessive normal saline~~'''~~ infusion (dilutional/hyperchloremic)		*Excessive normal saline infusion (dilutional/hyperchloremic)
	*Hyperalimentation (TPN)		*Hyperalimentation (TPN)

	==Evaluation==		==Evaluation==
	*[[BMP]]: calculate anion gap (Na - Cl - HCO3), check potassium		*[[BMP]]: calculate anion gap (Na - Cl - HCO3), check potassium
	*~~'''~~Urine anion gap~~'''~~ (Na + K - Cl) helps distinguish GI from renal cause:		*Urine anion gap (Na + K - Cl) helps distinguish GI from renal cause:
	**~~'''~~Negative urine AG~~'''~~ = GI loss (kidneys appropriately excreting NH4+)		**Negative urine AG = GI loss (kidneys appropriately excreting NH4+)
	**~~'''~~Positive urine AG~~'''~~ = renal cause (RTA — kidneys cannot excrete acid)		**Positive urine AG = renal cause (RTA — kidneys cannot excrete acid)
	*Urine pH: >5.5 suggests Type 1 RTA		*Urine pH: >5.5 suggests Type 1 RTA
	*Serum potassium: low (Type 1, 2 RTA, diarrhea), high (Type 4 RTA)		*Serum potassium: low (Type 1, 2 RTA, diarrhea), high (Type 4 RTA)
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	==Management==		==Management==
	*Treat underlying cause (e.g., volume replacement for diarrhea)		*Treat underlying cause (e.g., volume replacement for diarrhea)
	*~~'''~~Sodium bicarbonate~~'''~~ for severe acidosis (pH <7.1) or symptomatic		*Sodium bicarbonate for severe acidosis (pH <7.1) or symptomatic
	*Correct potassium abnormalities		*Correct potassium abnormalities
	*Stop offending medications (acetazolamide, excessive NS)		*Stop offending medications (acetazolamide, excessive NS)

Danbot: Expanded with concise EM-focused content: HARDUPS mnemonic, urine AG interpretation, management

2026-03-21T00:31:57Z

Expanded with concise EM-focused content: HARDUPS mnemonic, urine AG interpretation, management

@@ Line 1: / Line 1: @@
 ==Background==
 ==Clinical Features==
 ==Differential Diagnosis==
 {{Non anion gap acidosis}}
 ==Evaluation==
 ==Management==
 ==Disposition==
 ==See Also==
+*[[Metabolic acidosis]]
-==External Links==
+*[[Anion gap metabolic acidosis]]
 ==References==
 <references/>
-[[Category:FEN]][[Category:Renal]]
+[[Category:FEN]]

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-24T11:51:24Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 11:51, 24 July 2016
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	==Differential Diagnosis==		==Differential Diagnosis==
	{{Non anion gap acidosis}}		{{Non anion gap acidosis}}
	==~~Diagnosis~~==		==Evaluation==

	==Management==		==Management==

Ostermayer at 08:34, 10 June 2016

2016-06-10T08:34:55Z

← Older revision		Revision as of 08:34, 10 June 2016
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	==References==		==References==
	<references/>		<references/>

			[[Category:FEN]][[Category:Renal]]

Ostermayer: Created page with "==Background== ==Clinical Features== ==Differential Diagnosis== {{Non anion gap acidosis}} ==Diagnosis== ==Management== ==Disposition== ==See Also== ==External Links==..."

2016-06-10T08:34:10Z

Created page with "==Background== ==Clinical Features== ==Differential Diagnosis== {{Non anion gap acidosis}} ==Diagnosis== ==Management== ==Disposition== ==See Also== ==External Links==..."

New page

==Background==

==Clinical Features==

==Differential Diagnosis==
{{Non anion gap acidosis}}
==Diagnosis==

==Management==

==Disposition==

==See Also==

==External Links==

==References==
<references/>