buncha/health & fitness/anion-gap

Anion Gap

Sodium (Na+)

mEq/L

Chloride (Cl−)

mEq/L

Bicarbonate (HCO3−)

mEq/L

Units

Include potassium in the gap (less common; some clinicians prefer Na+K)

Serum albumin (g/dL, optional)

For albumin-corrected AG. Add ~2.5 mEq/L per 1 g/dL below 4.0.

Anion gap

12.0mEq/L

Normal

Reference: Normal AG typically 8–12 mEq/L (varies by lab, some report 8–16). High-anion-gap causes include lactic acidosis, ketoacidosis, renal failure, toxic ingestions (methanol, ethylene glycol, salicylates). Normal-AG metabolic acidosis suggests GI bicarbonate loss or renal tubular acidosis. Albumin correction matters in critical illness — every 1 g/dL drop in albumin lowers the apparent AG by about 2.5 mEq/L.

For clinical reference only. Use alongside the full picture: pH, pCO2, lactate, ketones, history.

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About Anion Gap

Calculate the anion gap (AG = Na − [Cl + HCO3]) with optional albumin correction (AG + 2.5 × [4 − albumin]). Reference bands include normal (8–12 mEq/L), borderline (12–16), raised metabolic acidosis (16–25), and very high HAGMA (>25). Optional potassium inclusion for the Na+K variant. Use it to differentiate high-AG metabolic acidosis (lactic, ketoacidosis, renal failure, toxic ingestions) from normal-AG (GI bicarbonate loss, RTA). Albumin correction is critical in hypoalbuminaemic patients where the raw AG underestimates the true gap. For clinical reference only — interpret alongside pH, pCO2, lactate, ketones, and the clinical picture.

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