Etiologies-of-AG-Metabolic-Acidosis

“GOLD MARK” = Glycols, Oxoproline, Lactic, D-Lactic, Methanol, ASA, Renal, Ketoacidosis

酮酸、乳酸、水楊酸 甲醇、丙(烯)醇、乙二醇 腎不好

diabetic ketoacidosis

diabetes mellitus, alcoholism, starvation (NEJM 2015;372:546)

參考➡️ Type I diabetes mellitus

Lactic acidosis

Renal failure

Accumulation of organic anions (eg, phosphates, sulfates, etc.)

Ingestions

(NEJM 2020; 382:2544)

參考➡️ Salicylate toxicity

• Glycols: Ethylene (antifreeze) → metab to glycolic and oxalic acids
• Propylene (pharmaceutical solvent, eg, IV diazepam, lorazepam, and phenobarbital; antifreeze) → lactic acidosis
• Diethylene (brake fluid) → diglycolic acid
• 5-oxoproline (pyraglutamic acid): acetaminophen → ↑ organic acid 5- oxoproline in susceptible Pts (malnourished, female, renal failure)
• Methanol (windshield fluid, antifreeze, solvents, fuel): metab to formic acid
• Aspirin: early resp alkalosis (CNS stim) + late metab acidosis (impairs oxidative phosphorylation → inorganic acids (eg, ketones, lactate)

Explain by ChatGPT

• Renal failure: accumulation of organic anions (eg, phosphates, sulfates, etc.)

1. Diabetic ketoacidosis is caused by diabetes mellitus, alcoholism, or starvation.
2. Lactic acidosis is caused by accumulation of organic anions.
3. Renal failure is caused by ingestion of glycols, propylene, diethylene, 5-oxoproline, methanol, aspirin, or other organic compounds.

窩的英文不太好

• 腎功能衰竭：有機陰離子（如磷酸鹽、硫酸鹽等）的積累

1. 糖尿病酮症酸中毒是由糖尿病、酒精中毒或飢餓引起的。
2. 乳酸性酸中毒是有機陰離子蓄積所致。
3. 腎功能衰竭是由攝入乙二醇、丙烯、二乙烯、5-氧代脯氨酸、甲醇、阿司匹林或其他有機化合物引起的。