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Anion Gap + Delta AG Delta bicarbonate ratio Calculator

Anion gap (AG) = [Na+] – ([Cl-]+[HCO3-])
※ Correction is required when albumin is low.
Corrected AG = AG + 2.5 × (4.5 – albumin)
(For every 1 g/dL decrease in albumin from 4.5 g/dL, serum AG decreases by 2.5)

Delta AG / Delta bicarbonate ratio = (AG-12)/(24-HCO3)
※ Delta-Delta ratio is automatically calculated if high anion gap is detected.










※ Reference ranges for Anion Gap vary among studies, but this calculator uses 12 mmol/L as the reference.

For normal anion gap, calculate Urine anion gap.
For high anion gap, consider GOLD MARK and calculate delta-delta and Osmolar gap.

If Delta-delta ratio is between 1 and 2 → No mixed disorder.
If less than 1 → High AG Metabolic Acidosis + {Normal AG Metabolic Acidosis or Respiratory Alkalosis}.
If greater than 2 → High AG Metabolic Acidosis + {Metabolic Alkalosis or Respiratory Acidosis}.

GOLD MARK ?

  • G : glycols [ethylene and propylene]
  • O : 5-oxoproline [pyroglutamic acid]
  • L : l-lactate
  • D : d-lactate
  • M : methanol
  • A : aspirin
  • R : renal failure
  • R : rhabdomyolysis
  • K : ketoacidosis
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