Adjusted anion-gap calculator, corrected for albumin.
Calculates the adjusted serum anion-gap, corrected for the influence of co-existing hypoalbuminemia or hyperalbuminemia.
Research authors: Feldman M, Soni N, Dickson B.
Details Formula Study characteristics Files & References
★★
Model author
Model ID
242
Version
1.14
Revision date
2018-01-09
MeSH terms
  • Anion Gap
  • Acidosis
  • Hypoalbuminemia
  • Albumins
  • Model type
    Custom model (Calculation)
    Status
    public
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    Formula

    Additional information

    Study population: 
    5328 consecutive patients aged 1 month to 102 years. Most patients (3750; 70%) had a normal albumin, but 1158 had hypoalbuminemia (< or =3.4 g/dL); 420 had hyperalbuminemia (> or =4.7 g/dL).

    Model development: 
    Serum albumin, total protein, and electrolyte concentrations were measured in all patients. Relationships between serum albumin or total protein and the anion gap were analyzed by linear regression.

    Source: 
    Feldman et al. Influence of hypoalbuminemia or hyperalbuminemia on the serum anion gap. J Lab Clin Med. 2005;146(6):317-20.

    Study Population

    Total population size: 5328
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    Females: {{ model.numberOfFemales }}

    Continuous characteristics

    Name LL Q1 Median Q3 UL Unit
    Age 0.1 53 102 years

    Categorical characteristics

    Name Subset / Group Nr. of patients
    Albumin level Hypoalbuminemia (≤34 g/L) 1158
    Normoalbuminemia (35-46 g/L) 3750
    Hyperalbuminemia (≥47 g/L) 420

    The albumin-adjusted anion-gap is:
    ...
    mmol/l

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    Result
    Note
    Notes are only visible in the result download and will not be saved by Evidencio

    The albumin-adjusted anion-gap is: mmol/l

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    Outcome stratification

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    Conditional information

    Result interpretation


    Reference values:
    An adjusted anion-gap of 8 +/- 3 mmol/l is considered normal.

    How this model should be used: 
    Before considering whether a disorder associated with an increased or decreased anion gap is present, the anion gap should be first adjusted for abnormal serum albumin concentrations. In a study by Feldman et al (2005) in 5328 consecutive patients, highly significant correlations between either serum albumin or total protein and the anion gap were reported (P < 0.001). The initial assessment of an anion gap as being increased, normal, or decreased changed in 44% of the patients with hypo- or hyperalbuminemia once anion gap had been adjusted with the abovementioned formula.

    Important notice:
    The anion-gap can vary widely, reflecting both differences in the methods that are used to measure its constituents and substantial interindividual variability.

    Source:
    Feldman et al. Influence of hypoalbuminemia or hyperalbuminemia on the serum anion gap. J Lab Clin Med. 2005;146(6):317-20.

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    Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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