URINE ANION GAP
by Brian Rosenthal and Stephen Fadem
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The urine anion gap measures positive and negative ions. Since urine ammonia is not measured, it is the gap anion. Healthy kidneys can excrete ammonia and trap it as ammonium to rid the body of excess acid (H+). In renal tubular acidosis or in any condition where ammonia is not secreted and trapped, the gap will be less.
The UAG is not valid if the urine sodium is < 20 mEq/L or in cases of volume depletion, low chloride excretion.
References
Hilton,JG, et al. The urine anion gap: the critical clue to resolve a diagnostic dilemma in a patient with ketoacidosis
Diabetes Care, 7:486-490,1984.
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