Correlation of Urine Ammonium with Urine Osmolal Gap in High Anion Gap Matabolic Acidosis: Comparison to Urine Anion Gap.
- Author:
Yong Young JUNG
;
Sung Woo HAN
;
Min Sook PARK
;
Gwan Soo KIM
;
Gheun Ho KIM
;
Yoon Sook CHO
;
Kwon Wook JOO
;
Jin Suk HAN
;
Suhng Gwon KIM
;
Jung Sang LEE
- Publication Type:Original Article
- Keywords:
Urine ammonium;
Urine osmolal gap;
Urine anion gap;
High anion gap metabolic acidosis
- MeSH:
Acid-Base Equilibrium*;
Acidosis*;
Ammonium Compounds*;
Humans;
Ketosis
- From:Korean Journal of Medicine
1997;53(1):61-68
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: Urine anion gap(UAG) and urine osmolal gap(UOG) were proposed as indirect measures of urine ammonium(NF4+). While the former is known to have its usefulness limited to hyperchloremic metabolic acidosis, the latter is reported to have its correlation with urine NE4+ in ketoacidosis. This study was undertaken to evaluate the correlation of urine NH with IJOG in high anion gap metabolic acidosis(AGMA) and to compare it with UAG. METHODS: We measured urine NH' by enzymatic determination, UOG(=0.5 X [urine osmolality-{2 X (Na++K+)+urea+glucose)]), and UAG(=Na++K+-Cl-) in 18 patients(serum AG=24.4+/-1.6mmol/L ) with AGMA. RESULTS: When they were grouped into those with acute disorders(n=11) and those with chronic disorder(n=7), urine Nk4+ concentration was higher (p<0.05) in the acute(35.6+/-7.7mmol/L) than in the chronic(3.8+/-0.9mmol/L) group. The UOG was higher (p<0.05) in the acute(73.2+/-18.9mmol/L) than in the chronic(6.3+/-8.7mmol/L) group, but the UAG had no difference between the two groups. When both groups of the patients were considered together, urine NH concentration correlated with the UOG (r=0.90, p<0.01), but not with the UAG. While the patients with lower urine NH4+ excretion(<30mmol/d) had the UOG<40mmol/L, those with higher urine NH' excretion(>40mmol/d) had the UOG>40mmol/L. CONCLUSION: In contrast to the UAG, the UOG has a significant correlation with urine NH4+ in AGMA.
