Internal Medicine · Emergency Medicine · Nephrology

Delta Gap Ratio (ΔAG/ΔHCO₃⁻) calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

Serum sodium (mmol/L)

Serum chloride (mmol/L)

Serum bicarbonate (mmol/L)

Reference anion gap (mEq/L)

Reference anion gap used for delta calculations; 12 mEq/L is a conventional adult reference value.

Reference serum bicarbonate (mmol/L)

Reference serum bicarbonate used for delta bicarbonate; 24 mmol/L is a common laboratory reference midpoint.

Result

Complete all required inputs to calculate the score.

Formula inputs

Serum sodium (mmol/L)Accepted range: 100 to 180
Serum chloride (mmol/L)Accepted range: 70 to 140
Serum bicarbonate (mmol/L)Accepted range: 0 to 50
Reference anion gap (mEq/L)Accepted range: 6 to 16
Reference serum bicarbonate (mmol/L)Accepted range: 20 to 28

Primary source

Wrenn K et al. The delta (delta) gap: an approach to mixed acid-base disorders. Ann Emerg Med. DOI: 10.1016/S0196-0644(90)80477-7. PMID: 2305019. Scope: delta gap ratio = Δanion gap / Δbicarbonate, where Δanion gap = measured anion gap − reference anion gap and Δbicarbonate = reference bicarbonate − measured bicarbonate. (1990)

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