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Hypoalbuminemia (or hypoalbuminaemia) is a medical sign in which the level of albumin in the blood is low. [1] This can be due to decreased production in the liver, increased loss in the gastrointestinal tract or kidneys, increased use in the body, or abnormal distribution between body compartments.
Anion gap can be classified as either high, normal or, in rare cases, low. Laboratory errors need to be ruled out whenever anion gap calculations lead to results that do not fit the clinical picture. Methods used to determine the concentrations of some of the ions used to calculate the anion gap may be susceptible to very specific errors.
Normal anion gap metabolic acidosis/acidemia; Hypokalemia; Urinary stone formation (related to alkaline urine, hypercalciuria, and low urinary citrate). [3] Nephrocalcinosis (deposition of calcium in the substance of the kidney) Bone demineralisation (causing rickets in children and osteomalacia in adults)
Hyperparathyroidism – can cause hyperchloremia and increase renal bicarbonate loss, which may result in a normal anion gap metabolic acidosis. Patients with hyperparathyroidism may have a lower than normal pH, slightly decreased PaCO2 due to respiratory compensation, a decreased bicarbonate level, and a normal anion gap. [3]
Renal tubular acidosis (RTA) is a medical condition that involves an accumulation of acid in the body due to a failure of the kidneys to appropriately acidify the urine. [1] In renal physiology, when blood is filtered by the kidney, the filtrate passes through the tubules of the nephron, allowing for exchange of salts, acid equivalents, and other solutes before it drains into the bladder as urine.
Etiologies of proximal RTA may be divided into primary, isolated causes and secondary causes, or those related to another disease. [2] Primary causes are frequently single gene hereditary disorders. Secondary disorders can be divided into familial disorders, acquired disorders, and those related to other clinical entities. [citation needed]
Arterial blood gases will indicate low pH, low blood HCO 3, and normal or low PaCO 2. In addition to arterial blood gas, an anion gap can also differentiate between possible causes. The Henderson-Hasselbalch equation is useful for calculating blood pH, because blood is a buffer solution.
Large anion gap acidosis is usually present during the initial stage of poisoning. However, acidosis has a large number of differential diagnoses , including poisoning from methanol, salicylates , iron , isoniazid , paracetamol , theophylline , or from conditions such as uremia or diabetic and alcoholic ketoacidosis .
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