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Serum Anion Gap (AG) Calculator

Written by the Elysia Tools team · Last updated:2026-08-08

This tool is for informational purposes only and does not constitute medical, financial, or legal advice; consult a qualified professional for advice.

Calculate the serum Anion Gap (AG) to classify metabolic acidosis. Standard formula AG = Na⁺ − Cl⁻ − HCO₃⁻ (mmol/L), or AG = Na⁺ + K⁺ − Cl⁻ − HCO₃⁻ with optional potassium. A high AG (≈ >12, or >20 with K⁺) indicates accumulation of unmeasured anions (lactic acidosis, ketoacidosis, renal failure, and toxins such as methanol/ethylene glycol, salicylates — mnemonic GOLD-MARK). A normal AG (8–12) during metabolic acidosis points to a hyperchloremic (normal-anion-gap) acidosis: diarrhea, renal tubular acidosis, saline resuscitation. A low AG (<3–6) is usually hypoalbuminemia, also hypercalcemia/hypermagnesemia, lithium, cationic IgG paraproteins, or bromide pseudo-hyperchloraemia. Optional albumin correction AG_corrected = AG + 2.5 × (4.0 − albumin g/dL) avoids missing a high-AG acidosis in hypoalbuminemia. Derived from Kraut CJASN 2007, Figge 1998, and MDCalc. Interpret with blood gas and full clinical context. Not medical advice.

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Tool usage guide

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Key facts

Category
Health
Input types
checkbox, number
Output type
json
Sample coverage
4
API ready
Yes

Overview

The Serum Anion Gap (AG) Calculator uses sodium, chloride, and bicarbonate values to calculate the anion gap and classify metabolic acidosis. You can optionally include potassium and albumin correction for hypoalbuminemia. Results are reported in mmol/L and should be interpreted with blood gas findings and the full clinical context.

When to use

  • Assess whether metabolic acidosis has a high or normal anion gap.

© 2026 Elysia Tools. All rights reserved.

Check for a potentially masked high anion gap when serum albumin is low.
  • Compare anion gap calculations using the standard formula or a formula that includes potassium.
  • How it works

    1. 1Enter serum sodium, chloride, and bicarbonate values in mmol/L.
    2. 2Optionally enable potassium and enter a potassium value to use AG = Na⁺ + K⁺ − Cl⁻ − HCO₃⁻.
    3. 3Optionally enter albumin in g/dL to calculate the albumin-corrected anion gap.
    4. 4The calculator returns the AG, optional corrected AG, formula used, and an anion-gap category.

    Use cases

    • Screening electrolyte results for high anion gap metabolic acidosis.
    • Reviewing possible hyperchloremic or normal-anion-gap metabolic acidosis.
    • Adjusting the anion gap for hypoalbuminemia during clinical or educational review.

    Examples

    1. Identifying a high anion gap

    Clinician reviewing electrolyte results

    Background

    A patient has sodium of 140 mmol/L, chloride of 104 mmol/L, and bicarbonate of 10 mmol/L.

    Problem

    Calculate the standard serum anion gap and classify the result.

    How to use

    Enter sodium 140, chloride 104, and bicarbonate 10. Leave potassium and albumin blank.

    Outcome

    The calculator returns AG = 26 mmol/L and classifies it as high anion gap metabolic acidosis.

    2. Correcting the anion gap for low albumin

    Medical student studying acid-base interpretation

    Background

    A patient has sodium of 138 mmol/L, chloride of 104 mmol/L, bicarbonate of 24 mmol/L, and albumin of 2.0 g/dL.

    Problem

    Determine whether hypoalbuminemia changes the interpretation of the anion gap.

    How to use

    Enter sodium 138, chloride 104, bicarbonate 24, and albumin 2.0. Do not enable potassium.

    Outcome

    The uncorrected AG is 10 mmol/L, while the albumin-corrected AG is 15 mmol/L.

    FAQ

    What formula does the calculator use?

    By default, it uses AG = Na⁺ − Cl⁻ − HCO₃⁻. If potassium is enabled, it uses AG = Na⁺ + K⁺ − Cl⁻ − HCO₃⁻.

    What values are required?

    Serum sodium, chloride, and bicarbonate are required. Potassium and albumin are optional.

    Why enter serum albumin?

    Albumin correction can reveal a higher anion gap when hypoalbuminemia makes the uncorrected AG appear normal.

    How are high and normal anion gaps classified?

    Without potassium, an AG above approximately 12 is generally high, while 8–12 is commonly considered normal. Reference ranges shift when potassium is included.

    Is this calculator medical advice?

    No. Use the result as a calculation aid and interpret it with blood gases, laboratory data, and clinical findings.

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