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Published ahead of print on July 26, 2007
Journal of the American Society of Nephrology
© 2007 American Society of Nephrology
doi: 10.1681/ASN.2006121408
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UP FRONT MATTERS: Clinical Commentary

Use of the {Delta}AG/{Delta}HCO3- Ratio in the Diagnosis of Mixed Acid-Base Disorders

Asghar Rastegar 1

Department of Medicine, Yale University School of Medicine, New Haven, Connecticut


1 To whom correspondence should be addressed. E-mail: asghar.rastegar{at}yale.edu.


  Abstract

When a strong acid is added to plasma, one expects a quantitative relationship between excess anion gap ({Delta}AG) and bicarbonate deficit ({Delta}HCO3-) with the {Delta}AG/{Delta}HCO3- ratio close to unity. If true, then this ratio could be used to diagnose mixed acid-base disorders in patients with metabolic acidosis. Although the mean ratio in selected patients is close to unity, this ratio also has a wide range, making its use in individual patients problematic. The ratio should therefore be used cautiously in making a diagnosis of mixed acid-base disorders.


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A. Rastegar
Clinical Utility of Stewart's Method in Diagnosis and Management of Acid-Base Disorders
Clin. J. Am. Soc. Nephrol., July 1, 2009; 4(7): 1267 - 1274.
[Abstract] [Full Text] [PDF]


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