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  • Title: Non-Anion Gap Metabolic Acidosis: A Clinical Approach to Evaluation.
    Author: Rastegar M, Nagami GT.
    Journal: Am J Kidney Dis; 2017 Feb; 69(2):296-301. PubMed ID: 28029394.
    Abstract:
    Acid-base disturbances can result from kidney or nonkidney disorders. We present a case of high-volume ileostomy output causing large bicarbonate losses and resulting in a non-anion gap metabolic acidosis. Non-anion gap metabolic acidosis can present as a form of either acute or chronic metabolic acidosis. A complete clinical history and physical examination are critical initial steps to begin the evaluation process, followed by measuring serum electrolytes with a focus on potassium level, blood gas, urine pH, and either direct or indirect urine ammonium concentration. The present case was selected to highlight the differential diagnosis of a non-anion gap metabolic acidosis and illustrate a systematic approach to this problem.
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