Friday, April 20, 2007

Friday April 20, 2007
Quick way of differentiating non-gap metabolic acidosis


Once you determine from serum chemistry that you have a non-gap metabolic acidosis,

  • Check the urine anion gap (UNa + UK – UCl)
  • If urine anion gap is positive, it is a renal cause (e.g. RTA; in reality only validated for types I, IV)
  • If urine anion gap is negative, the cause is extra-renal.

Mnemonic to remember non gap metabolic acidosis is

HARD UP

Hyperalimentation
Acetazolamide
RTA (Renal)
Diarrhea
Ureterosigmoidostomy
Pancreatic fistula



Related previous pearl:
Metabolic acidosis from HIV meds