Serum Anion Gap

In cases of hypoalbuminemia or hyperalbuminemia, the corrected anion gap result may be more accurate. 

If no albumin is entered, or if albumin is within the normal range, no correction is necessary. 

Management of an anion gap acidosis focuses on correcting the underlying cause and varies based on the specific etiology.

Anion Gap Metabolic Acidosis: MUDPILERS

• Methanol

• Uremia

• Diabetic ketoacidosis/alcoholic ketoacidosis

• Paraldehyde

• Isoniazid

• Lactic acidosis

• Ethanol/ethylene glycol

• Rhabdomyolysis/renal failure

• Salicylates

Non-Anion Gap Acidosis: HARDUPS

• Hyperalimentation

• Acetazolamide

• Renal tubular acidosis

• Diarrhea

• Ureteroenterostomy (or ureteroenteric fistula)

• Post-hypocapnia

• Spironolactone

Acute Respiratory Acidosis: 

• CNS depression (drugs/CVA)

• Airway obstruction

• Pneumonia

• Pulmonary edema

• Hemo/pneumothorax

• Myopathy

Chronic Respiratory Acidosis:

• COPD
• Restrictive lung disease
• Any hypoventilation state

Metabolic Alkalosis: CLEVER PD

• Contraction

• Licorice

• Endocrine causes (Conn's, Cushings, or Bartter's Syndrome)

• Vomiting

• Excess alkali

• Refeeding alkalosis

• Post-hypercapnia

• Diuretics

Respiratory Alkalosis: CHAMPS (think speed up breathing)

• Central Nervous System (CNS) disease

• Hypoxia

• Anxiety

• Mechanical ventilators

• Progesterone

• Salicylates/sepsis