Calculation Results
About This Calculator
Calculate serum Anion Gap, albumin-corrected anion gap, delta ratio (Δ-Δ), and uncover mixed high-gap vs normal-gap (non-gap) metabolic acidosis disorders.
Frequently Asked Questions
Why must the serum anion gap be corrected for albumin?
Serum albumin represents the largest pool of circulating unmeasured anions. For every 1.0 g/dL drop in serum albumin below normal (4.0 g/dL), the baseline anion gap falls by approximately 2.5 mEq/L. In critically ill, malnourished, or septic patients with hypoalbuminemia, an apparent normal anion gap can mask a severe high anion gap acidosis.
What does the Delta-Delta (Δ-Δ) ratio reveal?
The Delta ratio compares the increase in the anion gap (ΔAG) to the fall in bicarbonate (ΔHCO3). A ratio of 1.0 to 2.0 indicates pure HAGMA. A ratio < 0.8 indicates a mixed HAGMA and normal-gap acidosis (e.g. DKA plus diarrhea). A ratio > 2.0 indicates concurrent metabolic alkalosis (e.g. vomiting or chronic hypercapnia).
What does the GOLDMARK mnemonic stand for in acid-base medicine?
GOLDMARK modernizes the older MUDPILES mnemonic for high anion gap acidosis: Glycols (ethylene/propylene glycol), Oxoproline (chronic acetaminophen toxicity), L-lactate, D-lactate, Methanol, Aspirin (salicylates), Renal failure (uremia), and Ketoacidosis (diabetic, alcoholic, starvation).
What is the typical normal anion gap range in modern clinical labs?
Using modern ion-selective electrode chemistry analyzers, normal baseline serum anion gap without potassium is 8 to 12 mEq/L (previously 10 to 14 mEq/L).