Non-Anion Gap Metabolic Acidosis

Etiology

  • Loss of bicarbonate is off-set by rise in chloride
  • This allows acidosis to occur, with AG remaining normal
  • Common causes of Non-AG metabolic acidosis include: resuscitation w/large volumes of Normal Saline (high chloride content), losses of bicarbonate in GI tract (secretory diarrhea), loss of bicarb in urinary tract (types 1 and 4 renal tubular acidosis)

Risk Factors

  • CKD
  • Medications
  • Can have concurrent AG and Non-AG acidosis

Symptoms

  • Symptoms are based on underlying cause
  • Diarrhea (bicarb loss); CKD related; Medications, other
  • Non-specific symptoms could include: weakness, shortness of breath (compensatory tachypnea), confusion, other

Tests