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Hyperchloremic acidosis is a form of metabolic acidosis associated with a normal anion gap, a decrease in plasma bicarbonate concentration, and an increase in plasma chloride concentration (see anion gap for a fuller explanation). Although plasma anion gap is normal, this condition is often associated with an ''increased'' urine anion gap, due to the kidney's inability to secrete ammonia. ==Causes== In general, the cause of a hyperchloremic metabolic acidosis is a ''loss of base'', either a gastrointestinal loss or a renal loss. *Gastrointestinal loss of bicarbonate (HCO3) * * Severe diarrhea (vomiting will tend to cause hypochloraemic alkalosis). * * Pancreatic fistula with loss of bicarbonate rich pancreatic fluid. * * Nasogastric tube losses in the context of small bowel obstruction and loss of alkaline proximal small bowel secretions. * * Chronic laxative abuse. *Renal causes * * Proximal renal tubular acidosis with failure of HCO3− resorption, or * * Distal Renal Tubular Acidosis with failure of H+ secretion. * * Long term use of a carbonic anhydrase inhibitor such as Acetazolamide *Other causes * * Ingestion of Ammonium chloride, Hydrochloric acid, or other acidifying salts. * * The Treatment and Recovery phase of diabetic ketoacidosis. * * Volume resuscitation with 0.9% Normal Saline provides a chloride load such that infusing more than 3-4L causes acidosis. * * Hyperalimentation fluids (''i.e.'', total parenteral nutrition) 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「hyperchloremic acidosis」の詳細全文を読む スポンサード リンク
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