Clinical usefulness of the serum anion gap. 2006

Sik Lee, and Kyung Pyo Kang, and Sung Kyew Kang
Division of Nephrology, Department of Internal Medicine, Chonbuk National University Medical School, Chonbuk, Korea.

The anion gap in the serum is useful in the interpretation of acid-base disorders and in the diagnosis of other conditions. In the early 1980s, ion-selective electrodes for specific ionic species were introduced for the measurement of serum electrolytes. This new method has caused a shift of the anion gap from 12±4 mEq/L down 6±3 mEq/L. It is worthy for clinicians to understand the range of normal anion gap and the measuring methods for serum sodium and chloride in the laboratories that support their practice. While an increase in the anion gap is almost always caused by retained unmeasured anions, a decrease in the anion gap can be generated by multiple mechanisms.

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