尿中アニオンギャップ
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
Wikipedia preview
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)
[Wiki en表示]
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 |
paCO2 = 40 |
paO2 = 95 |
pH = 7.40 |
ALVEOLAR GAS: |
|
pACO2 = 36 |
pAO2 = 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. ›
Components and results of urine tests (CPT 81000–81099)
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|
Protein |
- Albumin
- Myoglobin
- hCG
- Leukocyte esterase
- Urine pregnancy test
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Small molecules |
- Ketone bodies
- Glucose
- Urobilinogen
- Bilirubin
- Creatinine
|
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Blood cells |
|
|
Chemical properties |
- Urine specific gravity
- Urine osmolality
- Urine pH
- Urine anion gap
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Other |
|
|
UpToDate Contents
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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
Related Links
- Measurement of the urine anion gap (UAG) and/or urine osmolal gap (UOG) may be helpful in the evaluation of patients with a normal anion gap (hyperchloremic) metabolic acidosis by providing an estimate of urinary ammonium (NH4 ...
- Urine Anion Gap The three main causes of normal anion gap acidosis are: Loss of HCO3- from Gastrointestinal tract (diarrhea) Loss of HCO3- from the Kidneys (RTAs) Administration of acid Distinguishing between the above 3 ...
★リンクテーブル★
[★]
- 英
- urine anion gap, urinary anion gap
- 同
- 尿アニオンギャップ
- 関
- アニオンギャップ
- 水・電解質と酸塩基平衡 改訂第2版 p.150
定義
- [Na+] + [K+] + [NH4+] + (その他陽イオン) = [Cl-] + (その他陰イオン)
- [Na+] + [K+] - [Cl-] = ( (その他陰イオン) - (その他陽イオン) ) - [NH4+]
- [Na+] + [K+] - [Cl-] ≡ uAG
- ∴ uAG = ( (その他陰イオン) - (その他陽イオン) ) - [NH4+] = 80 - [NH4+]
- 正常値は0
解釈
高値
- +25程度
- 尿中へのNH4+の分泌が低下している病態。ex. 遠位尿細管性アシドーシス
低値
- -30程度
- 尿中へのNH4+の分泌が亢進する病態。ex. 高Cl性代謝性アシドーシス。
[★]
- 関
- cleft、crevice、crevicular、interstice
[★]
[★]
- 関
- anal、anus
[★]
グラム
- 関
- gram