Global Health
Delta factor
Determination of serum anion gap (AG) is a vital step within the differential diagnosis of acid-base disorders, especially metabolic acidosis (Emmett, 2023). The delta ratio in metabolic acidosis is a calculated value that helps determine the presence of concomitant acid-base disorders in patients with metabolic acidosis.
The coefficient gives considered one of 4 results shown within the table below.
| Less than 0.4 | Normal anion gap metabolic acidosis (i.e. hyperchloremia) |
| 0.4-1 | Mixed high anion gap metabolic acidosis and normal metabolic acidosis AG |
| 1-2 | Uncomplicated high anion gap metabolic acidosis, also called “pure high anion gap metabolic acidosis”
|
| Greater than 2 | Suggests previously elevated HCO3–
|
Emmett, M. (May 4, 2022) Delta anion gap to delta HCO3 ratio in patients with high anion gap metabolic acidosis. https://www.uptodate.com/contents/the-delta-anion-gap-delta-hco3-ratio-in-residents-with-a-high-anion-gap-kwasica-metabolica
Rastegar A. (2007). Application of DeltaAG/DeltaHCO3- index within the diagnosis of mixed acid-base imbalance. , (9), 2429–2431. https://doi.org/10.1681/ASN.2006121408