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urinary anion gap

urine Na+ + urine K+ - urine Cl- Indications: - is used as a rough approximation of urine [NH4+] * urine chloride approximates urine [NH4+] Reference interval: - 30-50 meq/L Clinical significance: - a metabolic acidosis* of extrarenal orign is suggested by a large negative urine anion gap due to significant urine NH4+ excretion - a metabolic acidosis* of renal orign is suggested by a positive urine anion gap due to minimal urine NH4+ excretion * normal anion gap Increases: - metabolic acidosis due to renal tubular acidosis type 1 Decreases: - a negative urinary anion gap associated with GI loss of HCO3-

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anion gap

General

urine chemistry test

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11, 15, 17, 18, 19. American College of Physicians, Philadelphia 1998, 2009, 2015, 2018, 2021. - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022