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Albumin-Corrected Anion Gap

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mEq/L
mEq/L
mEq/L
g/dL

Anion Gap

Albumin-Corrected Anion Gap

About

The Albumin-Corrected Anion Gap adjusts the standard anion gap for hypoalbuminemia, which is common in hospitalized patients. Each 1 g/dL decrease in albumin below 4.0 g/dL reduces the anion gap by approximately 2.5 mEq/L, potentially masking an elevated anion gap acidosis. The Delta-Delta ratio (Delta Gap) further classifies mixed acid-base disorders by comparing the change in anion gap to the change in bicarbonate.

Formula

Anion Gap (AG) = Na − (Cl + HCO₃)
Corrected AG = AG + 2.5 × (4.0 − Albumin)
Delta-Delta = (Corrected AG − 12) / (24 − HCO₃)

Interpretation

ParameterInterpretation
Corrected AG ≤ 12Normal anion gap
Corrected AG > 12Anion gap metabolic acidosis
Delta-Delta < 1Concurrent non-AG metabolic acidosis
Delta-Delta 1 – 2Pure AG metabolic acidosis
Delta-Delta > 2Concurrent metabolic alkalosis

References

  1. Figge J, et al. Anion gap and hypoalbuminemia. Crit Care Med. 1998;26(11):1807-1810.
  2. Berend K, et al. Physiological approach to assessment of acid-base disturbances. N Engl J Med. 2014;371(15):1434-1445.

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For educational and informational purposes only. Not intended to replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional.