A normal-anion-gap metabolic acidosis occurs in patients with –
Correct Answer: Diarrhoea
Description: Causes of Non-Anion Gap Acidosis
I Gastrointestinal bicarbonate loss
Diarrhea
External pancreatic or small-bowel drainage
Ureterosigmoidostomy, jejunal loop, ileal loop
Drugs
1. Calcium chloride (acidifying agent)
Magnesium sulfate (diarrhea)
Cholestyramine (bile acid diarrhea)
II. Renal acidosis
A. Hypokalemia
Proximal RTA (type 2)
Distal (classic) RTA type 1)
B. Hyperkalemia
1. Generalized distal nephron dysfunction (type 4 RTA)
Mineralocorticoid deficiency
Mineralocorticoid resistance
Na+ delivery to distal nephron
Tubulointerstitial disease
Ammonium excretion defect
III. Drug-induced hyperkalemia (with renal insufficiency)
Potassium-sparing diuretics (amiloride, triamterene, spironolactone)
Trimethoprim
Pentamidine
Angiotensin-converting enzyme inhibitors and AT-II receptor blocker.
Nonsteroidal anti-inflammatory drugs
Cyclosporine
IV Other
A. Acid loads (ammonium chloride, hyperalimentation)
B. Loss of potential bicarbonate: ketosis with ketone excretion
C. Expansion acidosis (rapid saline administration)
D. Hippurate
E. Cation exchange resins.
Category:
Medicine
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