3: Acid-Base Disorders
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- 3.2: The Anion Gap
- The term anion gap (AG) represents the concentration of all the unmeasured anions in the plasma. The negatively charged proteins account for about 10% of plasma anions and make up the majority of the unmeasured anion represented by the anion gap under normal circumstances. The acid anions (e.g., lactate, acetoacetate, sulfate) produced during a metabolic acidosis are not measured as part of the usual laboratory biochemical profile.
- 3.3: The Delta Ratio
- The Delta Ratio is sometimes useful in the assessment of metabolic acidosis and is related to the anion gap and buffering; it will be discussed here before a discussion of metabolic acidosis. The Delta Ratio is defined as: Delta Ratio=Increase in Anion Gap/Decrease in bicarbonate.
- 3.4: The Urinary Anion Gap
- The urinary anion gap can help to differentiate between GIT and renal causes of a hyperchloraemic metabolic acidosis.