What is it about?
The Editorial simply emphasizes the situations where the Urine anion gap (UAG) is a useful indirect marker of urinary ammonium, namely in the evaluation of people presenting with a low level of plasma bicarbonate. This commentary explains why the UAG cannot be used in the context of Chronic Kidney Disease (CKD). This is a situation where the kidney cannot produce enough ammonium and moreover there are changes in other anions such as phosphate and sulfate that further obscure the relationship between the UAG and ammonium. In CKD Urine ammonium should be measured directly .
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Why is it important?
Physicians should be reminded when the UAG can be useful and when it cannot be used.
Perspectives
This commentary explains why the UAG cannot be used in the context of Chronic Kidney Disease (CKD) which is shown by the data in original paper by Raphael et al on the same issue of CJASN.
Daniel Batlle
Northwestern University
Read the Original
This page is a summary of: The Urine Anion Gap in Context, Clinical Journal of the American Society of Nephrology, January 2018, American Society of Nephrology,
DOI: 10.2215/cjn.13791217.
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