Archive for the ‘HAGMA’ Tag

What are the common causes of high-anion-gap metabolic acidosis?   Leave a comment

K  etoacidosis (diabetic)
U  raemia
S  alicylates
S  ubstances (ethylene glycol, paraldehyde, isoniazid)
M  ethanol
A  lcoholic ketoacidosis
L  actic acidosis (from sepsis, shock, AMI, seizures, rhabdomyolysis)

M  ethanol
U  raemia
D  iabetic ketoacidosis (DKA)
P  araldehyde
I  soniazid
L  actate
E  thylene glycol
S  alicylates

Three other anion-gap generating organic acids have been recognised:

  • D-lactic acid (short bowel syndrome)
  • 5-oxoproline or pyroglutamic acid (chronic paracetamol use in predisposed subset)
  • propylene glycol (solvent used in several parenteral medications)



  1. AN Mehta, JB Emmett, M Emmett. GOLD MARK: an anion gap mnemonic for the 21st century. The Lancet 2008/9;372(9642):892.
  2. JL Duewall et al. 5-oxoproline (pyroglutamic) acidosis associated with chronic paracetamol use. Bayler University Medical Centre Proceedings 2010;23(1):19-20

Posted July 14, 2010 by absinthemisia in Renal Medicine

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