Anion Gap Calculator

Hypoalbuminemia: A low level of albumin, a protein found in the blood, can lead to a decrease in anion gap values. This occurs because albumin is a negatively charged protein and contributes to the overall anion concentration in the blood. When albumin levels are low, fewer negatively charged particles are present, resulting in a lower anion gap.

Hyperalbuminemia: Conversely, high levels of albumin can increase anion gap values. Increased albumin concentrations lead to more negatively charged particles in the blood, elevating the anion gap.

Hypercalcemia: Elevated levels of calcium can influence anion gap values. Calcium is a cation, and increased concentrations can affect the balance between cations and anions, leading to higher anion gap values.

Hyperkalemia: Similarly, high levels of potassium in the blood can impact anion gap values. Potassium is a cation, and elevated concentrations can disrupt the balance between cations and anions, resulting in an increased anion gap.

Hypernatremia: Elevated sodium levels can also affect anion gap values. Sodium is a cation, and higher concentrations can contribute to a greater imbalance between cations and anions, leading to an elevated anion gap.

Laboratory Errors: It is crucial to consider the possibility of laboratory errors when interpreting anion gap values. Mistakes in blood sample collection, handling, or analysis can result in inaccurate results. Healthcare professionals should ensure proper protocols are followed during the testing process to minimise the likelihood of errors.

Medications and Substances: Certain medications or substances can influence anion gap values. For example, salicylates, such as aspirin, can lead to an increased anion gap. It is important to review the patient's medication history and consider any potential effects on anion gap values.

Diabetic Ketoacidosis (DKA): DKA is a life-threatening complication of diabetes, most commonly seen in individuals with type 1 diabetes. It occurs when there is a shortage of insulin, leading to the breakdown of fatty acids and the production of ketone bodies. The accumulation of ketones results in an elevated anion gap metabolic acidosis.

Lactic Acidosis: Lactic acidosis occurs when there is an excess production or decreased clearance of lactic acid in the body. This can be caused by conditions such as severe infections, shock, heart failure, liver disease, or certain medications. Lactic acidosis leads to an elevated anion gap and is often associated with significant tissue hypoperfusion.

Renal Failure: In the setting of renal failure, the kidneys are unable to effectively excrete acids or regulate acid-base balance. This can result in the accumulation of acids, such as phosphoric acid and sulfuric acid, leading to an elevated anion gap metabolic acidosis.

Toxins and Ingestions: Ingestion of certain toxins or substances can cause an elevated anion gap metabolic acidosis. For example, ethylene glycol, which is found in antifreeze, is metabolised into toxic compounds that lead to an increase in the anion gap. Methanol and salicylates (aspirin) are other examples of substances that can cause an elevated anion gap metabolic acidosis.

Starvation or Prolonged Fasting: During periods of prolonged fasting or starvation, the body relies on fatty acid metabolism for energy production. This can lead to the production of ketone bodies, resulting in an elevated anion gap metabolic acidosis.

Inherited Metabolic Disorders: Certain inherited metabolic disorders, such as maple syrup urine disease, propionic acidemia, or methylmalonic acidemia, can cause an elevated anion gap metabolic acidosis. These disorders involve defects in the metabolism of amino acids and organic acids.