CAUSES OF METABOLIC ACIDOSIS

Types

• Normal anion gap vs wide anion gap

OR

• Hyperchloraemic vs normal chloride

The Anion Gap

AG = [Na⁺ + K ⁺] - [HCO^3- + Cl ^-]

(normal range 10-14)

Wide AG metabolic acidosis

• Lactic
• Ketotic
• Renal failure
• Poisonings

Lactic acidosis

Lactic acidosis - Type A (Impaired tissue perfusion)

• Hypovolaemia
• Sepsis

Lactic acidosis - Type B

• Metformin
• Thiamine deficiency

Ketoacidosis - Causes

• Diabetic
• Alcoholic
• Starvation

Poisons and metabolic acidosis - 'PESTICIDE'

Normal AG acidosis - causes

• 'USEDCARP'
  • Uterosigmoidostomy
  • Small bowel fistula
  • Extra Chloride
  • Diarrhoea/Diuretics
  • Carbonic anhydrase inhibitors/Cholestyramine
  • Adrenal insufficiency
  • RTA/Renal failure
  • Pancreatic fistula/Pyelonephritis