Delta-Delta Gap (Delta Ratio)

Identifies mixed metabolic acid-base disorders in patients with elevated anion gap metabolic acidosis.

mEq/L

Serum sodium

mEq/L

Serum chloride

mEq/L

Serum bicarbonate (or measured HCO3 from ABG)

g/dL

For albumin-corrected anion gap (optional)

Enter electrolytes to calculate delta-delta gap

Clinical Notes & Warnings

  • Normal AG varies by lab (traditionally 12, modern electrodes ~6-10).
  • Albumin-corrected AG = AG + 2.5 * (4 - Albumin).
  • Some references use 0.8-1.2 as pure HAGMA range.
  • Delta Gap >+6 suggests metabolic alkalosis; <-6 suggests NAGMA.

The delta ratio quantifies whether the fall in bicarbonate matches the rise in anion gap. A ratio of 1 means pure HAGMA.