Causes of hyperchloraemic (normal anion gap) metabolic acidosis
Core concept
- Normal anion gap acidosis = HCO3 is lost, or acid excretion fails - not acid gained
- Cl- rises to preserve electroneutrality -> hyperchloraemia, normal AG
- Contrast with a raised AG, where an unmeasured anion (lactate, ketone, oxalate, salicylate) replaces the bicarbonate
- Two mechanisms, and the urinary anion gap separates them
- GI loss of HCO3 - the kidney is working normally
- Renal failure of acid excretion - RTA
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