Clinical acid-base pathophysiology: Disorders of plasma anion gap

Orson W. Moe, Daniel Fuster

Research output: Contribution to journalReview articlepeer-review

33 Scopus citations


The plasma anion gap is a frequently used parameter in the clinical diagnosis of a variety of conditions. The commonest application of the anion gap is to classify cases of metabolic acidosis into those that do and those that do not leave unmeasured anions in the plasma. While this algorithm is useful in streamlining the diagnostic process, it should not be used solely in this fashion. The anion gap measures the difference between the unmeasured anions and unmeasured cations and thus conveys much more information to the clinician than just quantifying anions of strong acids. In this chapter, the significance of the anion gap is emphasized and several examples are given to illustrate a more analytic approach to using the clinical anion gap; these include disorders of low anion gap, respiratory alkalosis and pyroglutamic acidosis.

Original languageEnglish (US)
Pages (from-to)559-574
Number of pages16
JournalBest Practice and Research: Clinical Endocrinology and Metabolism
Issue number4
StatePublished - 2003


  • Acid-base
  • Alkalosis
  • Anion gap
  • Pyroglutamic acidosis
  • Respiratory

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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