Metabolic Acidosis
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Mengyao Tang Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts

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Andrew Z. Fenves Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts

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  • 1.

    Fenves AZ, Emmett M: Approach to patients with high anion gap metabolic acidosis: Core curriculum 2021. Am J Kidney Dis 78: 590600, 2021 PubMed

  • 2.

    Kraut JA, Madias NE: Serum anion gap: Its uses and limitations in clinical medicine. Clin J Am Soc Nephrol 2: 162174, 2007 PubMed

  • 3.

    Pierce NF, Fedson DS, Brigham KL, Mitra RC, Sack RB, Mondal A: The ventilatory response to acute base deficit in humans. Ann Intern Med 72: 633640, 1970 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Albert MS, Dell RB, Winters RW: Quantitative displacement of acid-base equilibrium in metabolic acidosis. Ann Intern Med 66: 312322, 1967 PubMed

  • 5.

    Fulop M: A guide for predicting arterial CO2 tension in metabolic acidosis. Am J Nephrol 17: 421424, 1997 PubMed

  • 6.

    Hamm LL, Nakhoul N, Hering-Smith KS: Acid-base homeostasis. Clin J Am Soc Nephrol 10: 22322242, 2015 PubMed

  • 7.

    Weiner ID, Hamm LL: Molecular mechanisms of renal ammonia transport. Annu Rev Physiol 69: 317340, 2007 PubMed

  • 8.

    Garibotto G, Sofia A, Robaudo C, Saffioti S, Sala MR, Verzola D, et al.: Kidney protein dynamics and ammoniagenesis in humans with chronic metabolic acidosis. J Am Soc Nephrol 15: 16061615, 2004 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Harvey AM: Classics in clinical science: James L. Gamble and “Gamblegrams.” Am J Med 66: 904906, 1979 PubMed

  • 10.

    Peitzman SJ: The flame photometer as engine of nephrology: A biography. Am J Kidney Dis 56: 379386, 2010 PubMed

  • 11.

    Feldman M, Soni N, Dickson B: Influence of hypoalbuminemia or hyperalbuminemia on the serum anion gap. J Lab Clin Med 146: 317320, 2005 PubMed

  • 12.

    Rastegar A: Use of the DeltaAG/DeltaHCO3 ratio in the diagnosis of mixed acid-base disorders. J Am Soc Nephrol 18: 24292431, 2007 PubMed

  • 13.

    Mehta AN, Emmett JB, Emmett M: GOLD MARK: An anion gap mnemonic for the 21st century. Lancet 372: 892, 2008 PubMed

  • 14.

    Azim A, Hu B, Gilligan S, et al.: How I evaluate a high anion gap metabolic acidosis. Clin J Am Soc Nephrol 19: 525527, 2024 PubMed

  • 15.

    Fenves AZ, Mojtahed A, Nisavic M, Massoth LR: Case 13-2019: A 54-year-old man with alcohol withdrawal and altered mental status. N Engl J Med 380: 16571665, 2019 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Schillaci LP, DeBrosse SD, McCandless SE: Inborn errors of metabolism with acidosis: Organic acidemias and defects of pyruvate and ketone body metabolism. Pediatr Clin North Am 65: 209230, 2018 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Solares I, Heredia-Mena C, Castelbón FJ, Jericó D, Córdoba KM, Fontanellas A, et al.: Diagnosis and management of inborn errors of metabolism in adult patients in the emergency department. Diagnostics (Basel) 11: 2148, 2021 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Fukao T, Nakamura K: Advances in inborn errors of metabolism. J Hum Genet 64: 65, 2019 10.1038/s10038-018-0535-7 PubMed

  • 19.

    Kreisberg RA: Lactate homeostasis and lactic acidosis. Ann Intern Med 92: 227237, 1980 PubMed

  • 20.

    Kraut JA, Madias NE: Lactic acidosis. N Engl J Med 371: 23092319, 2014 PubMed

  • 21.

    Kraut JA, Madias NE: Treatment of acute metabolic acidosis: A pathophysiologic approach. Nat Rev Nephrol 8: 589601, 2012 PubMed

  • 22.

    Yeku OO, Medford AJ, Fenves AZ, Uljon SN: Case 15-2021: A 76-year-old woman with nausea, diarrhea, and acute kidney failure. N Engl J Med 384: 19431950, 2021 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Bianchetti DGAM, Amelio GS, Lava SAG, Bianchetti MG, Simonetti GD, Agostoni C, et al.: D-lactic acidosis in humans: Systematic literature review. Pediatr Nephrol 33: 673681, 2018 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Reichard GA Jr., Owen OE, Haff AC, Paul P, Bortz WM: Ketone-body production and oxidation in fasting obese humans. J Clin Invest 53: 508515, 1974 PubMed

  • 25.

    Al Alawi AM, Al Flaiti A, Falhammar H: Lactation ketoacidosis: A systematic review of case reports. Medicina (Kaunas) 56: 299, 2020 PubMed

  • 26.

    Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN: Hyperglycemic crises in adult patients with diabetes. Diabetes Care 32: 13351343, 2009 PubMed

  • 27.

    Palmer BF, Clegg DJ: Euglycemic ketoacidosis as a complication of SGLT2 inhibitor therapy. Clin J Am Soc Nephrol 16: 12841291, 2021 PubMed

  • 28.

    Adrogué HJ, Wilson H, Boyd AE 3rd, Suki WN, Eknoyan G: Plasma acid-base patterns in diabetic ketoacidosis. N Engl J Med 307: 16031610, 1982 PubMed

  • 29.

    Long B, Lentz S, Gottlieb M: Alcoholic ketoacidosis: Etiologies, evaluation, and management. J Emerg Med 61: 658665, 2021 PubMed

  • 30.

    Raphael KL: Metabolic acidosis in CKD: Core curriculum 2019. Am J Kidney Dis 74: 263275, 2019 PubMed

  • 31.

    Pham AQ, Xu LH, Moe OW: Drug-induced metabolic acidosis [published online ahead of print Dec 16, 2015]. F1000 Res doi:10.12688/f1000research.7006.1 PubMed

  • 32.

    Palmer BF, Clegg DJ: Salicylate toxicity. N Engl J Med 382: 25442555, 2020 PubMed

  • 33.

    Fenves AZ, Kirkpatrick HMI 3rd, Patel VV, Sweetman L, Emmett M: Increased anion gap metabolic acidosis as a result of 5-oxoproline (pyroglutamic acid): A role for acetaminophen. Clin J Am Soc Nephrol 1: 441447, 2006 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Emmett M: Acetaminophen toxicity and 5-oxoproline (pyroglutamic acid): A tale of two cycles, one an ATP-depleting futile cycle and the other a useful cycle. Clin J Am Soc Nephrol 9: 191200, 2014 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Hundemer GL, Fenves AZ: Acquired 5-oxoproline acidemia successfully treated with N-acetylcysteine. Proc Bayl Univ Med Cent 30: 169170, 2017 PubMed

  • 36.

    Nigwekar SU, Thadhani R, Brandenburg VM: Calciphylaxis. N Engl J Med 378: 17041714, 2018 PubMed

  • 37.

    Hundemer GL, Fenves AZ, Phillips KM, Emmett M: Sodium thiosulfate and the anion gap in patients treated by hemodialysis. Am J Kidney Dis 68: 499500, 2016 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Farese S, Stauffer E, Kalicki R, Hildebrandt T, Frey BM, Frey FJ, et al.: Sodium thiosulfate pharmacokinetics in hemodialysis patients and healthy volunteers. Clin J Am Soc Nephrol 6: 14471455, 2011 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Kraut JA, Mullins ME: Toxic alcohols. N Engl J Med 378: 270280, 2018 PubMed

  • 40.

    Kraut JA, Xing SX: Approach to the evaluation of a patient with an increased serum osmolal gap and high-anion-gap metabolic acidosis. Am J Kidney Dis 58: 480484, 2011 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Carlisle EJ, Donnelly SM, Vasuvattakul S, Kamel KS, Tobe S, Halperin ML: Glue-sniffing and distal renal tubular acidosis: Sticking to the facts. J Am Soc Nephrol 1: 10191027, 1991 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Rastegar M, Nagami GT: Non-anion gap metabolic acidosis: A clinical approach to evaluation. Am J Kidney Dis 69: 296301, 2017 PubMed

  • 43.

    Palmer BF, Clegg DJ: The use of selected urine chemistries in the diagnosis of kidney disorders. Clin J Am Soc Nephrol 14: 306316, 2019 PubMed

  • 44.

    Goldstein MB, Bear R, Richardson RMA, Marsden PA, Halperin ML: The urine anion gap: A clinically useful index of ammonium excretion. Am J Med Sci 292: 198202, 1986 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Batlle DC, Hizon M, Cohen E, Gutterman C, Gupta R: The use of the urinary anion gap in the diagnosis of hyperchloremic metabolic acidosis. N Engl J Med 318: 594599, 1988 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Uribarri J, Oh MS: The urine anion gap: Common misconceptions. J Am Soc Nephrol 32: 10251028, 2021 PubMed

  • 47.

    Dyck RF, Asthana S, Kalra J, West ML, Massey KL: A modification of the urine osmolal gap: An improved method for estimating urine ammonium. Am J Nephrol 10: 359362, 1990 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 48.

    Raphael KL, Ix JH: Correlation of urine ammonium and urine osmolal gap in kidney transplant recipients. Clin J Am Soc Nephrol 13: 638640, 2018 PubMed

  • 49.

    Uribarri J, Goldfarb DS, Raphael KL, Rein JL, Asplin JR: Beyond the urine anion gap: In support of the direct measurement of urinary ammonium. Am J Kidney Dis 80: 667676, 2022 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 50.

    Gennari FJ, Weise WJ: Acid-base disturbances in gastrointestinal disease. Clin J Am Soc Nephrol 3: 18611868, 2008 PubMed

  • 51.

    Cruz DN, Huot SJ: Metabolic complications of urinary diversions: An overview. Am J Med 102: 477484, 1997 PubMed

  • 52.

    Tanrikut C, McDougal WS: Acid-base and electrolyte disorders after urinary diversion. World J Urol 22: 168171, 2004 PubMed

  • 53.

    Palmer BF, Kelepouris E, Clegg DJ: Renal tubular acidosis and management strategies: A narrative review. Adv Ther 38: 949968, 2021 PubMed

  • 54.

    Soleimani M, Rastegar A: Pathophysiology of renal tubular acidosis: Core curriculum 2016. Am J Kidney Dis 68: 488498, 2016 PubMed

  • 55.

    Rodríguez Soriano J: Renal tubular acidosis: The clinical entity. J Am Soc Nephrol 13: 21602170, 2002 PubMed

  • 56.

    Lush DJ, King JA, Fray JC: Pathophysiology of low renin syndromes: Sites of renal renin secretory impairment and prorenin overexpression. Kidney Int 43: 983999, 1993 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 57.

    Wagner CA, Unwin R, Lopez-Garcia SC, Kleta R, Bockenhauer D, Walsh S: The pathophysiology of distal renal tubular acidosis. Nat Rev Nephrol 19: 384400, 2023 PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 58.

    Rose BD, Post TW: Renal tubular acidosis. In: Clinical Physiology of Acid-Base and Electrolyte Disorders, 5th Ed., New York, McGraw-Hill, 2001, pp 612625

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