Which conditions cause a non-anion gap (AG) metabolic acidosis?

Updated: Oct 10, 2018
  • Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

The conditions that may cause a non-AG metabolic acidosis are as follows:

  • GI loss of HCO3- - Diarrhea

  • Enterocutaneous fistula (eg, pancreatic) - Enteric diversion of urine (eg, ileal loop bladder), pancreas transplantation with bladder drainage

  • Renal loss of HCO3- - Proximal RTA (type 2), carbonic anhydrase inhibitor therapy (including topiramate [4] )

  • Failure of renal H+ secretion - Distal RTA (type 1), hyperkalemic RTA (type 4), renal failure

  • Acid infusion - Ammonium chloride, hyperalimentation

  • Other - Rapid volume expansion with normal saline


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