Anion gap

Bulletin (April - June 1998 Vol.6 No.2)

Increase Anion Gap with Acidosis
Increased endogenous acid
Drugs/toxins Albuterol Carbon monoxide Cocaine Cyanide Diazoxide Ethanol Hydrogen sulfide Isoniazid Isopropyl alcohol Phenformin	Propylene glycol Theophylline Tricyclic antidepressants Hyperglycemic-hyperosmolar nonketotic coma Ketoacidosis Alcoholic Diabetic starvation Lactic Acidosis
Increased exogenous acid
Drugs Salicylate (overdose) Iron Methenamine mandelate Nalidixic acid Paraldehyde	Toxic agents   Ethylene glycol Formaldehyde Methanol Oxalic acid Toluene (chronic)
Decrease acid secretion
Renal failure Acute Chronic
Inborn errors of metabolism

Increased Anion Gap without Acidosis
Alkalosis Metabolic Respiratory Anion, inorganic, increased Phosphate Sulfate Cation, unmeasured, decreased Hypocalcemia Hypokalemia Hypomagnesemia	Dehydration Hyperalbuminemia Sodium salts of: Unmeasured anions Acetate Citrate Lactate Antibiotics (high-dose) Carbenicillin Penicillin

Decreased Anion Gap
Dilution Drugs/toxins Bromide intoxication Lithium Toxicity Tromethamine (TRIS buffer, THAM) Hypercalcemia Hyperkalemia	Hypermagnesemia Hypernatremia (severe) Hyperviscosity Hypoalbuminemia Paraproteinemia Multiple myeloma, severe