Wide variation in serum anion gap measurements by chemistry analyzers

William D. Paulson, William L. Roberts, Aubrey A. Lurie, David D. Koch, Anthony W. Butch, James J. Aguanno

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


The traditional anion gap [AG = Na - Cl - (total CO2)] mean value of 12 mean value of 12 mEq/L was established during the 1970s with analyzer methods that are no longer used widely: No studies have systematically compared mean AG values from analyzers in current use. We used data from the healthy subjects obtained from 27 clinical laboratories, 5 manufacturers, and 8 publications to compute mean AG values from 1970s analyzers and 8 current analyzers. We also compared mean AG values by evaluating Na, Cl, and total CO2 data from the College of American Pathologists Chemistry Surveys (1990- 1996). Data from healthy subjects showed that overall mean AG values of the 9 analyzers ranged from 5.9 to 12.4 mEq/L. The pooled (ie, average) AG SD was 2.3 mEq/L. We then used the data of the Surveys and the mean value from 1 analyzer to compute predicted mean values for the other 7 current analyzers. Almost all mean AG values predicted from the Surveys agreed (within 1.5 mEq/L) with mean values from healthy subjects. These results show that mean values of analyzers vary widely, indicating that analytic bias strongly influences the AG. The results should be a useful guide for the AG measurements that can be expected from different analyzers.
Original languageEnglish (US)
Pages (from-to)735-742
Number of pages8
JournalAmerican Journal of Clinical Pathology
Issue number6
StatePublished - Jan 1 1998

Bibliographical note

Generated from Scopus record by KAUST IRTS on 2023-09-20

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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