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Differential diagnosis for metabolic acidosis (decreased SID) |
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| Renal tubular acidosis: |
Nonrenal: |
| urine SID (Na+ + K+ – Cl) > 0 |
urine SID (Na+ + K+ – Cl-) < 0 |
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|
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| Distal (type I): urine pH >5.5 |
Gastrointestinal: diarrhea, small |
| bowel/pancreatic drainage |
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| Proximal (type II): urine |
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| pH <5.5/low serum K+ |
Iatrogenic: parenteral nutrition, |
| saline, anion exchange resins |
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| Aldosterone deficiency (type IV): |
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| urine pH <5.5/high serum K+ |
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SID, strong ion difference. | |
Kellum Critical Care 2000 4:6 doi:10.1186/cc644 |
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