In which of the following condition normal anion gap metabolic acidosis is seen?
Alkali can be lost from the gastrointestinal tract in diarrhea or from the kidneys (renal tubular acidosis, A). In these disorders, reciprocal changes in and result in a normal anion gap. In pure non-AG acidosis, therefore, the increase in above the normal value approximates the decrease in . Causes of non anion gap acidosis: Gastrointestinal bicarbonate loss Diarrhea External pancreatic or small-bowel drainage Ureterosigmoidostomy, jejunal loop, ileal loop Drugs Calcium chloride (acidifying agent) Magnesium sulfate (diarrhea) Cholestyramine (bile acid diarrhea) Renal acidosis Hypokalemia Hyperkalemia Drug-induced hyperkalemia (with renal insufficiency) Potassium-sparing diuretics (amiloride, triamterene, spironolactone) Trimethoprim ACEIs and ARBs Nonsteroidal anti-inflammatory drugs Other Loss of potential bicarbonate: ketosis with ketone excretion Cation exchange resins Ref: DuBose, T.D. (2012). Chapter 47. Acidosis and Alkalosis. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
Diarrhoea
Renal failure
Lactic acidosis
Diabetic ketoacidosis