High Anion Gap Metabolic Acidosis (HAGMA)
Causes
- M - methanol
- U - uremia
- D - diabetic ketoacidosis (or other ketoacidosis: starvation ketoacidosis, alcoholic ketoacidosis)
- P - propylene glycol, paracetamol
- I - iron, INH, inborn errors of metabolism
- L - Lactate
- E - Ethylene glycol
- S - Salicylate
Pathogenesis
Normal Anion Gap Metabolic Acidosis (NAGMA)
Causes
- H - Hyperchloremia
- A - Acetazolamide, Addison's Disease
- R - Renal tubular acidosis
- D - Diarrhea, ileostomy, fistula
- U - Ureteroenterostomy
- P - Pancreatoenterostomy
Pathogenesis
- Addition of Hcl
- Normal saline
- NH4Cl
- TPN
- Now we put acetate in TPN which is metabolized to bicarbonate
- Loss of HCO3-
- Renal
- GI