Which of the following is a common cause of anion gap acidosis?

Diabetic ketoacidosis (DKA) is a well-recognized and common cause of anion gap acidosis. In DKA, there is an excessive production of ketoacids, primarily beta-hydroxybutyric acid and acetoacetic acid, due to a deficiency of insulin and increased lipolysis. As these ketoacids accumulate in the bloodstream, they contribute to an increased anion gap, which is the difference between the measured cations (mainly sodium) and the measured anions (mainly bicarbonate and chloride). The elevated level of ketoacids leads to metabolic acidosis, characterized by a significant gap in the usual balance of anions and cations, thus manifesting as anion gap acidosis.

While dehydration, renal failure, and hypovolemia can lead to metabolic acidosis through different mechanisms, they do not usually result in an elevated anion gap unless other factors are involved. For example, renal failure can cause a normal or increased anion gap depending on the underlying causes and associated conditions. Dehydration and hypovolemia might lead to metabolic acidosis primarily through lactic acidosis but are not direct causes of anion gap elevation in the same manner as diabetic keto