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High anion gap metabolic acidosis is a form of metabolic acidosis characterized by a high anion gap, which might be considered to be > 11 mEq/L. The list of agents that cause high anion gap metabolic acidosis is similar to but broader than the list of agents that cause a serum osmolal gap. High Anion Gap Metabolic acidosis is caused generally by the body producing too much acid or not producing enough bicarbonate. This is often an increase in lactic acid or ketoacids, or a sign of kidney failure, and more rarely may be caused by ingesting methanol or overdosing on aspirin. The Delta Ratio is a formula that can be used to assess elevated anion gap metabolic acidosis and to evaluate whether mixed acid base disorder (metabolic acidosis) is present. ==Causes== Causes include: The newest mnemonic was proposed in ''The Lancet'' reflecting current causes of anion gap metabolic acidosis: *G — glycols (ethylene glycol & propylene glycol) *O — oxoproline, a metabolite of paracetamol *L — L-lactate, the chemical responsible for lactic acidosis *D — D-lactate *M — methanol *A — aspirin *R — renal failure *K — ketoacidosis, ketones generated from starvation, alcohol, and diabetic ketoacidosis The mnemonic MUDPILES is commonly used to remember the causes of increased anion gap metabolic acidosis.〔(Anion Gap: Acid Base Tutorial, University of Connecticut Health Center )〕 *M — Methanol *U — Uremia (chronic kidney failure) *D — Diabetic ketoacidosis *P — Propylene glycol ("P" used to stand for Paraldehyde but this substance is not commonly used today) *I — Infection, Iron, Isoniazid, Inborn errors of metabolism *L — Lactic acidosis *E — Ethylene glycol (Note: Ethanol is sometimes included in this mnemonic as well, although the acidosis caused by ethanol is actually primarily due to the increased production of lactic acid found in such intoxication.) *S — Salicylates Another frequently used mnemonic is KARMEL. *K — Ketoacidosis *A — aspirin *R — Renal failure *M — Methanol *E — Ethylene glycol *L — Lactic acidosis Another frequently used mnemonic is KUPIN. *K — Ketoacidosis (DKA, AKA) *U — Uremia *P — Production (Lactic acidosis) *I — Ingestion (Ethylene glycol, methanol) *N — Need to Remember Drugs (aspirin, Metformin) The mnemonic for the (in comparison ) toxins is ACE GIFTs: Aspirin, Cyanide, Ethanolic ketosis, Glycols (ethylene and propylene ), Isoniazid, Ferrous iron, Toluene. Most of these cause a lactic acidosis. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「High anion gap metabolic acidosis」の詳細全文を読む スポンサード リンク
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