How is anion gap calculated in DKA?

How is anion gap calculated in DKA?

In clinical practice, the anion gap is calculated using three lab values (Na+, Cl-, and HCO3-). [Occasionally, you may see an alternative equation: Anion Gap = [Na+] + [K+] – [Cl-] – [HCO3-].

What is the formula for calculating anion gap?

Calculation relies on measuring specific cations, Na+ and K+ and specific anions, Cl- and HCO3-. The equation is as follows: (Na+ + K+) – (Cl- + HCO3-) = Anion Gap. The anion gap formula can be manipulated to expose the presence of unmeasured cations and anions as shown below.

What is the anion gap in DKA?

In mild DKA, anion gap is greater than 10 and in moderate or severe DKA the anion gap is greater than 12. These figures differentiate DKA from HHS where blood glucose is greater than 600 mg/dL but pH is greater than 7.3 and serum bicarbonate greater than 15 mEq/L.

Why do we check anion gap in DKA?

The anion gap blood test is used to show whether your blood has an imbalance of electrolytes or too much or not enough acid. Too much acid in the blood is called acidosis. If your blood does not have enough acid, you may have a condition called alkalosis.

Is an anion gap of 6 bad?

The normal (physiologic) range of the anion gap was defined as 6-14 mEq/L, and an anion gap >14.1 mEq/L was considered high.

What are the 3 P’s of DKA?

The three Ps of DKA:

• Polydipsia—thirst.
• Polyuria—urination.
• Polyphagia—appetite.

Is an anion gap of 7 normal?

The value of the anion gap is reported in milliequivalents per liter (mEq/L). Normal values are 3 to 11 mEq/L [4, 2]. Some older types of tests used different techniques to measure electrolytes, which give different results. The normal range for these older tests is 8 to 16 mEq/L [5, 6, 7].

Why does anion gap increase?

It is important because an increased anion gap usually is caused by an increase in unmeasured anions, and that most commonly occurs when there is an increase in unmeasured organic acids, that is, an acidosis3, 4). Acids (eg, lactate and pyruvate) are protons donors and must be buffered by bicarbonate.

Is an anion gap of 4 Bad?

A normal anion gap is generally considered to be 8 to 12 in a patient with a normal serum albumin concentration of 4.0 g/dL. In patients with hypoalbuminemia, the anion gap should be “corrected” by adding 2.5 to the calculated anion gap for every 1 g/dL decrease in albumin concentration.

What is the expected anion gap in diabetic ketoacidosis (DKA)?

In patients with diabetic ketoacidosis, the anion gap is elevated ([Na + K] – [Cl + HCO 3] greater than 10 mEq/L in mild cases and greater than 12 mEq/L in moderate and severe cases).

What is an elevated anion gap?

Elevated Anion Gap. An increase in an anion gap is most often due to some for of a metabolic acidosis, such as, ketoacidosis , lactic acidosis, acute/chronic kidney disease, toxic alcohol ingestion, and long term acetaminophen use.

What is the anion gap?

The anion gap is a measurement of the difference-or gap-between the negatively charged and positively charged electrolytes. If the anion gap is either too high or too low, it may be a sign of a disorder in your lungs, kidneys, or other organ systems.