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Updated: Jun 22, 2025

Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
Published on: November 27, 2019
Acetaminophen induced high anion gap metabolic acidosis: a potentially under-recognized consequence from a common
Dhruv Gaur1, Michael G Michalopulos1, Keri A Drake1
1Division of Pediatric Nephrology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas, 75390, USA.
None:
While metabolic acidosis is one of the most common complications in patients with chronic kidney disease (CKD), there are several uncommon etiologies that are challenging to diagnose. Here, we describe a patient on peritoneal dialysis who developed high anion gap metabolic acidosis secondary to acquired 5-oxoprolinemia from acetaminophen use. While CKD is a known risk factor for developing this potentially serious complication, this case further highlights how 5-oxoproline accumulation can occur, even with therapeutic dosing of acetaminophen.
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