Molecules in the body can have no charge on them, positive charges or negative charges. There must be as many positive charges as negative charges. One definition of an acid is as the concentration of positively charged hydrogen ions. Acidosis is the excess buildup of positive hydrogen ions, and it must be accompanied by an equal buildup of negatively charged molecules. A normal anion gap metabolic acidosis is generally accompanied by the buildup of negatively charged chloride ions, as opposed to another type of molecule. This type of acid buildup, characterized by excess hydrogen and chloride, has specific causes.
Gastrointestinal Causes
Another common negative ion in the body that counters the buildup of acid is bicarbonate. According to the Anaesthesia Education Website, if this is lost through the GI tract, such as what occurs with severe diarrhea, acidosis will result. Similarly, abnormal connection in the intestine called fistulas, or abnormal connections of the bile ducts or pancreatic ducts that contain fluid rich in bicarbonate, can lead to loss of bicarbonate and therefore acidosis.
Kidney Causes
A condition called renal tubular acidosis may cause a failure of the kidneys to retain enough bicarbonate in the body, or a failure to pump out enough hydrogen ions into the urine, resulting in a normal anion gap metabolic acidosis. The kidneys will also be unable to secrete acids in the urine if they suddenly shut down, a condition called acute renal failure.
Drug/Other Causes
According to the Merck Manual and Family Practice Notebook, certain drugs interfere with the kidney's reabsorption of bicarbonate into the body. Two of these include acetazolamide and mefenamic acid. Acidifying agents include calcium chloride, arginine, lysine, and ammonium chloride. A few others include sulfur toxicity, high potassium, magnesium sulfate and toluene.
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