Hyperchloremic acidosis

Hyperchloremic acidosis
Classification and external resources
ICD-10	E87.2
ICD-9	276.2
eMedicine	med/1071

Hyperchloremic acidosis is a form of metabolic acidosis associated with a normal anion gap, a decrease in plasma bicarbonate concentration, and in an increase in plasma chloride concentration (see anion gap for a fuller explanation). Although plasma anion gap is normal, this condition is often associated with an increased urine anion gap, due to the kidney's inability to secrete ammonia.

Causes

• Renal tubular acidosis failure of HCO₃^- resorption(i.e., proximal renal tubular acidosis, or overdose of carbonic anhydrase inhibitor) or failure of H⁺ secretion (i.e. in distal renal tubular acidosis)
• Renal failure
• Gastrointestinal loss of HCO₃^- with diarrhea (vomiting will tend to cause hypochloraemic alkalosis).
• Ingestions
  • Ammonium chloride, Hydrochloric acid
  • Hyperalimentation fluids (i.e., total parenteral nutrition)
• Zonisamide
• Acetazolamide
• Alcohol (such as ethanol) can affect anion gap by inducing alcohol dehydrogenase enzyme.

See also

• Anion gap
• Metabolic acidosis
• Pseudohypoaldosteronism

External links

• DDB 11673
• NIH - Renal Tubular Acidosis
• Kellum JA (February 2002). "Fluid resuscitation and hyperchloremic acidosis in experimental sepsis: improved short-term survival and acid-base balance with Hextend compared with saline". Crit. Care Med. 30 (2): 300–5. doi:10.1097/00003246-200202000-00006. PMID 11889298.