🧪 Delta Ratio (Delta-Delta) Calculator
Calculate the delta ratio (delta-delta) to uncover mixed metabolic acid–base disorders.
Clinical takeaway
Compares the rise in anion gap with the fall in bicarbonate.
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When to use
Detect a coexisting normal-gap acidosis or metabolic alkalosis in high-anion-gap acidosis.
How it works
Delta ratio = (AG − 12) / (24 − HCO₃). < 0.4 added NAGMA; 0.4–1 combined; 1–2 pure HAGMA; > 2 added metabolic alkalosis.
Key points
- Compares the rise in anion gap with the fall in bicarbonate.
- Reference AG and HCO₃ values are lab-dependent.
- Interpret with the full acid–base picture.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Measured anion gap | 24 mmol/L |
|---|---|
| Bicarbonate (HCO₃⁻) | 12 mmol/L |
→Delta ratio1.00
- Interpretation：1–2 — pure high-anion-gap metabolic acidosis.
- Formula：(AG − 12) / (24 − HCO₃)
Frequently asked questions
- What is Delta Ratio (Delta-Delta) Calculator?
- Calculate the delta ratio (delta-delta) to uncover mixed metabolic acid–base disorders.
- How is Delta Ratio (Delta-Delta) Calculator calculated? What is the core formula?
- Delta ratio = (AG − 12) / (24 − HCO₃). < 0.4 added NAGMA; 0.4–1 combined; 1–2 pure HAGMA; > 2 added metabolic alkalosis.
- When is Delta Ratio (Delta-Delta) Calculator used?
- Detect a coexisting normal-gap acidosis or metabolic alkalosis in high-anion-gap acidosis.
- What are the key clinical points for Delta Ratio (Delta-Delta) Calculator?
- Compares the rise in anion gap with the fall in bicarbonate. Reference AG and HCO₃ values are lab-dependent. Interpret with the full acid–base picture.
- What are the limits and cautions when using Delta Ratio (Delta-Delta) Calculator?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Delta Ratio (Delta-Delta) Calculator calculated in practice? Can you show a worked example?
- Inputs: Measured anion gap 24 mmol/L, Bicarbonate (HCO₃⁻) 12 mmol/L → Result: Delta ratio 1.00（Interpretation: 1–2 — pure high-anion-gap metabolic acidosis., Formula: (AG − 12) / (24 − HCO₃)）