Non-Anion Gap Metabolic Acidosis – USED CRAP
- Ureteroenterostomy/Ureterosigmoid connection- either because of surgical ureteral sigmoidostomy or a ureterosigmoid fistula as may occur in Crohn’s disease
- Small bowel fistula, steroid excess (Addison’s disease, iatrongenic)
- Extra chloride (NH4Cl or amino acid chlorides 2° to TPN)
- Diarrhea
- Carbonic Anhydrase inhibitors, CaCl ingestion, cholestyramine ingestion
- RTA types I (distal), II, (proximal), and IV (hyporeninemic hypoaldosteronism)
- Adrenal insufficiency (e.g. Addison’s disease), Alimentation (hyper-alimentation, including starting TPN), Ammonium Chloride ingestion
- Pancreatic fistula, Parenteral nutrition (TPN), hyperPTH, Post-hypocapnia
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