Normal Anion-Gap Acidosis (NAGMA) - Differential Diagnosis ...
989
Description

Normal Anion-Gap Acidosis (NAGMA) - Differential Diagnosis and Workup

1. Chloride intoxication

 - Normal saline infusion

 - Hyperalimentation

2. Renal loss of HCO3

 - renal insufficiency ( GFR 20-50 ml/min)

 - Acetazolamide therapy

 - hypoaldosteronism

 - RTA

3. GI loss of HCO3

 - Diarrhea.

 - high output fistulas.

 - Pancreatic/ Biliary drainage.

 - Chronic laxative abuse

 - Villous adenoma

 - losses via NGTube

 - Ureteroileostomy/ ureterosigmoidostomy

 - Surgical drains

Type 1: Distal RTA:

 - Impaired H+ secretion

 - Urine pH > 5.5

 - Serum K low/ normal

Type 2: Proximal RTA:

 - low HCO3 absorption

 - Urine pH< 5.5

 - Serum K: low/ normal

Type 4: Hyperkalemic RTA:

 - Urine pH > 5.5

 - Serum K high/normal



Dr. Ravi Singh @rav7ks



#Normal #NonAnionGap #Acidosis #Metabolic #NAGMA  #Differential #Diagnosis #Workup #causes #nephrology
Contributed by

Dr. Ravi Singh K
@rav7ks
Academic Hospitalist and APD @SinaiBmoreIMRes, Clinical reasoning,Simulation and POCUS enthusiast - https://twitter.com/rav7ks
0 Comments

Related content