Anion Gap ( AG ) = [ Na + ] [ Cl + HCO 3 ]

Δ AG = Δ HCO 3

Pure high anion gap metabolic acidosis

Δ AG < Δ HCO 3

High anion gap metabolic acidosis PLUS additional non-anion gap metabolic acidosis (i.e. RTA)

Δ AG > Δ HCO 3

High anion gap metabolic acidosis PLUS concurrent metabolic alkalosis (i.e. vomiting, hypercortisolism, hyperaldosteronism, contraction alkalosis)

Δ AG Δ HCO 3

High anion gap metabolic acidosis PLUS primary respiratory alkalosis (i.e. severe lactic acidosis, septic shock, etc.)