Which of the following is NOT a cause of high anion gap metabolic acidosis?

High anion gap metabolic acidosis is characterized by an increase in the anion gap, which usually indicates the presence of additional unmeasured anions in the blood. Common causes of high anion gap metabolic acidosis include uremia, lactic acidosis, and diabetic ketoacidosis (DKA), as these conditions lead to the accumulation of acids in the bloodstream.

Acute diarrhea primarily leads to normal anion gap metabolic acidosis, usually due to the loss of bicarbonate through the intestines rather than the accumulation of acids. In this scenario, bicarbonate is lost, but the addition of unmeasured anions is not significant, thus not contributing to a high anion gap. This distinction makes acute diarrhea not a cause of high anion gap metabolic acidosis, distinguishing it from the other listed conditions, which do contribute to this specific type of acidosis due to their mechanisms of acid production or retention.