Urinary Ammonium in Clinical Medicine: Direct Measurement and the Urine Anion Gap as a Surrogate Marker During Metabolic Acidosis.

Autor: Rehman MZ; Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL., Melamed M; Department of Medicine (Nephrology), Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY., Harris A; Department of Small Animal Clinical Sciences College of Veterinary Medicine, Gainesville, FL., Shankar M; Department of Nephrology, Institute of Nephro-urology, Bengaluru, India., Rosa RM; Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL., Batlle D; Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: d-batlle@northwestern.edu.
Jazyk: angličtina
Zdroj: Advances in kidney disease and health [Adv Kidney Dis Health] 2023 Mar; Vol. 30 (2), pp. 197-206.
DOI: 10.1053/j.akdh.2022.12.006
Abstrakt: Ammonium is the most important component of urinary acid excretion, normally accounting for about two-third of net acid excretion. In this article, we discuss urine ammonium not only in the evaluation of metabolic acidosis but also in other clinical conditions such as chronic kidney disease. Different methods to measure urine NH 4 + that have been employed over the years are discussed. The enzymatic method used by clinical laboratories in the United States to measure plasma ammonia via the glutamate dehydrogenase can be used for urine ammonium. The urine anion gap calculation can be used as a rough marker of urine ammonium in the initial bedside evaluation of metabolic acidosis such as in distal renal tubular acidosis. Urine ammonium measurements, however, should be made more available in clinical medicine for a precise evaluation of this important component of urinary acid excretion.
(Copyright © 2023. Published by Elsevier Inc.)
Databáze: MEDLINE
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