WordNet

make an opening or gap in (同)breach
a narrow opening; "he opened the window a crack" (同)crack
a conspicuous disparity or difference as between two figures; "gap between income and outgo"; "the spread between lending and borrowing costs" (同)spread
a difference (especially an unfortunate difference) between two opinions or two views or two situations
liquid excretory product; "there was blood in his urine"; "the child had to make water" (同)piss, pee, piddle, weewee, water
a unit of force equal to the force exerted by gravity; used to indicate the force to which a body is subjected when it is accelerated (同)gee, g-force
a negatively charged ion
black tropical American cuckoo

PrepTutorEJDIC

(壁・へいなどの)『割れ目』,『すき間』《+『in』+『名』》 / (連続するものの)『途切れ』,空白[部分]《+『in』+『名』》 / (意見・性格などの)『大きなずれ』《+『between』+『名』》 / (山の尾根を分断する)深い峡谷(峠) / …‘に'割れ目(すき間)を作る / 割れ目(すき間)ができる
尿,小便
陰イオン

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/03/14 02:14:55」(JST)

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Pathophysiology sample values
BMP/ELECTROLYTES:
Na⁺ = 140	Cl⁻ = 100	BUN = 20	/
			Glu = 150
K⁺ = 4	CO₂ = 22	PCr = 1.0	\
ARTERIAL BLOOD GAS:
HCO₃⁻ = 24	p_aCO₂ = 40	p_aO₂ = 95	pH = 7.40
ALVEOLAR GAS:
	p_ACO₂ = 36	p_AO₂ = 105	A-a g = 10
OTHER:
Ca = 9.5	Mg²⁺ = 2.0	PO₄ = 1
CK = 55	BE = −0.36	AG = 16
SERUM OSMOLARITY/RENAL:
PMO = 300	PCO = 295	POG = 5	BUN:Cr = 20
URINALYSIS:
UNa⁺ = 80	UCl⁻ = 100	UAG = 5	FENa = 0.95
UK⁺ = 25	USG = 1.01	UCr = 60	UO = 800
PROTEIN/GI/LIVER FUNCTION TESTS:
LDH = 100	TP = 7.6	AST = 25	TBIL = 0.7
ALP = 71	Alb = 4.0	ALT = 40	BC = 0.5
		AST/ALT = 0.6	BU = 0.2
AF alb = 3.0	SAAG = 1.0		SOG = 60
CSF:
CSF alb = 30	CSF glu = 60	CSF/S alb = 7.5	CSF/S glu = 0.4

The urine anion gap is calculated using measured ions found in the urine.^[1] It is used to aid in the differential diagnosis of metabolic acidosis.^[2]

The term "anion gap" without qualification usually implies serum anion gap. The "urine anion gap" is a different measure, principally used to determine whether the kidneys are capable of appropriately acidifying urine.

Calculation

Urine anion gap is calculated by subtracting the urine concentration of chloride (anions) from the concentrations of sodium plus potassium (cations):^[3]

= Na⁺ + K⁺ − Cl⁻

where the concentrations are expressed in units of milliequivalents/liter (mEq/L).

In contrast to the serum anion gap equation, the bicarbonate is excluded. This is because urine is acidic, so the bicarbonate level would be negligible.

Uses

Determining the cause of a metabolic acidosis that lacks a serum anion gap often depends on determining whether the kidney is appropriately excreting acid. The urine anion gap is an 'artificial' and calculated measure that is representative of the unmeasured ions in urine. Usually the most important unmeasured ion in urine is NH₄⁺ since it is the most important form of acid excretion by the kidney.^[4] Urine NH₄⁺ is difficult to measure directly, but its excretion is usually accompanied by the anion chloride. A negative urine anion gap can be used as evidence of increased NH₄⁺ excretion. In a metabolic acidosis without a serum anion gap:

A positive urine anion gap suggests a low urinary NH₄⁺ (e.g. renal tubular acidosis).
A negative urine anion gap suggests a high urinary NH₄⁺ (e.g. diarrhea).

References

^ Kim GH, Han JS, Kim YS, Joo KW, Kim S, Lee JS (January 1996). "Evaluation of urine acidification by urine anion gap and urine osmolal gap in chronic metabolic acidosis". Am. J. Kidney Dis. 27 (1): 42–7. doi:10.1016/S0272-6386(96)90029-3. PMID 8546137.
^ "Urine Anion Gap: Acid Base Tutorial, University of Connecticut Health Center". Retrieved 2009-04-11.
^ Julia A. McMillan; Ralph D. Feigin; Catherine DeAngelis; M. Douglas Jones (1 April 2006). Oski's pediatrics: principles & practice. Lippincott Williams & Wilkins. pp. 1–. ISBN 978-0-7817-3894-1. Retrieved 14 November 2010.
^ Goldstein, MB; Bear, R; Richardson, RM; Marsden, PA; Halperin, ML (Oct 1986). "The urine anion gap: a clinically useful index of ammonium excretion.". The American journal of the medical sciences 292 (4): 198–202. doi:10.1097/00000441-198610000-00003. PMID 3752165.

‹ The template below (Abnormal clinical and laboratory findings for urine) is being merged. See templates for discussion for the discussion that led to this result. ›

UpToDate Contents

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1. 代謝性アシドーシスにおける尿のアニオンギャップおよび浸透圧ギャップ urine anion and osmolal gaps in metabolic acidosis
2. 計算ツール：尿アニオンギャップ calculator urine anion gap
3. 遠位（I型）および近位（II型）尿細管性アシドーシスの病因および診断 etiology and diagnosis of distal type 1 and proximal type 2 renal tubular acidosis
4. 下痢に伴う酸塩基および電解質の異常 acid base and electrolyte abnormalities with diarrhea
5. D -乳酸アシドーシス d lactic acidosis

English Journal

Homozygous and compound heterozygous mutations in the ATP6V1B1 gene in patients with renal tubular acidosis and sensorineural hearing loss.

Mohebbi N, Vargas-Poussou R, Hegemann S, Schuknecht B, Kistler A, Wüthrich R, Wagner C.SourceInstitute of Physiology and Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland Division of Nephrology, University Hospital Zurich, Zurich, Switzerland Département de Génétique, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Zurich, Zurich, Switzerland Department of Neuroradiology, Institute for Medical Radiology, Zurich, Switzerland.
Clinical genetics.Clin Genet.2012 Apr 17. doi: 10.1111/j.1399-0004.2012.01891.x. [Epub ahead of print]
Mohebbi N, Vargas-Poussou R, Hegemann SCA, Schuknecht B, Kistler AD, Wüthrich RP, Wagner CA. Homozygous and compound heterozygous mutations in the ATP6V1B1 gene in patients with renal tubular acidosis and sensorineural hearing loss. Distal renal tubular acidosis (dRTA) is characterized by the inabi
PMID 22509993

Metabolic alkalosis from unsuspected ingestion: use of urine pH and anion gap.

Yi JH, Han SW, Song JS, Kim HJ.SourceRenal Division, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea.
American journal of kidney diseases : the official journal of the National Kidney Foundation.Am J Kidney Dis.2012 Apr;59(4):577-81. Epub 2012 Jan 20.
Underlying causes of metabolic alkalosis may be evident from history, evaluation of effective circulatory volume, and measurement of urine chloride concentration. However, identification of causes may be difficult for certain conditions associated with clandestine behaviors, such as surreptitious vo
PMID 22265393

Japanese Journal

Distal Renal Tubular Acidosis in HIV/AIDS Patient

Wan Isa Wan Yus Haniff,M Daud Kamaliah
Internal Medicine 50(16), 1765-1768, 2011
… The blood gases and serum electrolytes showed hyperchloremic normal anion gap metabolic acidosis with severe hypokalemia and alkaline urine. …
NAID 130000969385

<Originals>Age-associated Changes in Renal Function After Exhaustive Exercise in Healthy Males Ranging in Age From 8～80 Years Old

Suzuki Masato,Ishiyama Ikuo,Seino Tetsuya
Advances in exercise and sports physiology 12(3), 65-72, 2006-12-00
… Blood and urine samples were taken before, immediately after, and at 30/60 min after exercise. … A remarkable reduction in the concentration of Cl^- compared to that of Na^+ in urine 30 min after exercise may compensate for an increase in the urinary anion gap, which was the greater part of the increase in ULAE. …
NAID 110006151898

ＯＣＲＬ－１遺伝子異常を認めたＬｏｗｅ症候群の１例

芦田明,松村英樹,七里元督,中倉兵庫,吉川賢二,水沢慵一,玉井浩
日本小児腎臓病学会雑誌 16(2), 109-114, 2003
　症例は２歳，男児。６カ月時，先天性白内障と診断され手術治療をうけた。精神運動発達遅滞精査で入院時，血清ALP，CKの上昇，代謝性アシドーシス，高Ca尿症，汎アミノ酸尿，低分子蛋白尿，尺骨遠位端にくる病変化を認めた。加えて99mTcDMSA腎シンチでは腎へのRIの集積は低下した。これら検査所見からLowe症候群と診断し，原因遺伝子であるOCRL-1の検索とphosphatidylinositol …
NAID 130000077667