Renal Acid Base Disease

Front 1

Clinical definition of acidemia

Back 1

pH < 7.36

Front 2

Clinical definition of alkalemia

Back 2

pH > 7.44

Front 3

Formula for the serum anion gap (AG) and the normal range

Back 3

AG = [Na]-([Cl]+[HCO3])

Normal = 10 +/- 2

Front 4

Causes of an elevated anion gap

Back 4

1. retention of mineral acid anions (phosphate and sulfate) during severe renal failure
2. generation of organic anions (lactate, betahydroxybutryrate) during metabolic stress, or formate after injestion of toxin
3. Infusion of sodium lactate or sodium citrate in IV therapy

Front 5

Causes of a decreased anion gap

Back 5

1. Decreased serum albumin
2. Dilution of extracellular fluid
3. Increased positively charged proteins (multiple myeloma)

Front 6

What is the serum osmolal gap and what is the meaning if it is large

Back 6

Serum osmolal gap is the difference between the calculated serum osmolality and the measured serum osmolality. If the calculated osmolarity is more than 10 mOsm/L less then the measure osmolarity this indicates the presence of abnormal non-electrolytes (ex. ethanol,methanol)

Front 7

Calculate serum osmolality formula

Back 7

Osmolality = Electrolyte + normal non electrolyte = 2[Na]+ glucose + BUN

Front 8

Metabolic acidosis

Back 8

process that causes a primary decrease in serum pH by adding a non-volatile or an organic acid