What does a high anion gap indicate?

A high anion gap is typically indicative of metabolic acidosis resulting from an accumulation of unmeasured anions in the plasma. In clinical practice, the anion gap is calculated using the formula: anion gap = ([Na+] + [K+]) - ([Cl-] + [HCO3-]). A normal anion gap is generally between 8 and 12 mEq/L, and when the anion gap exceeds this range, it suggests that there are additional acids (such as lactate, ketoacids, or other organic acids) that are not routinely measured in standard biochemistry panels, causing an imbalance of electrolytes in the body.

In cases of conditions like diabetic ketoacidosis, renal failure, or lactic acidosis, unmeasured anions accumulate more than the measured cations and anions, leading to a high anion gap metabolic acidosis. This finding can guide clinicians towards specific diagnoses and prompt appropriate treatment strategies.

The other options either do not pertain directly to the significance of an anion gap or represent conditions that are unrelated to the concept of the anion gap itself. Therefore, recognizing a high anion gap as a possible signal of metabolic acidosis helps in effectively managing the underlying