A Modification of the Urine Osmolal Gap: An Improved Method for Estimating Urine Ammonium

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Abstract

A modification of the urine osmolal gap was evaluated as an estimate of urine [NH+4]. We proposed that: Urine [NH-4] =Urine osmolality – [2(Na+ + K+) + urea + glucose]/2 Spot urine samples were collected from normal volunteers and from individuals with ketonuria; the modified urine osmolal gap as well as two other previously described estimates of urine [NH+4] were compared with measured urine [NH+4]. There was a significant positive linear correlation between the urine [NH+4] and the modified urine osmolal gap in normal volunteers (r = 0.81; p < 0.01) and in individuals with ketonuria (r = 0.93; p < 0.001). The originally described urine osmolal gap greatly overestimated the urine [NH+4] but also showed a significant correlation. The urine anion gap was not a valid estimate of urine [NH+4] within the range of values measured in our subjects. The modified urine osmolal gap is an improvement over previously described estimates of urine [NH+4] and can be used as a single calculation in place of the other two.

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Journal

Journal ID (publisher-id): AJN

Journal ID (nlm-ta): Am J Nephrol

Journal ID (doi): 10.1159/issn.0250-8095

Title: American Journal of Nephrology

Publisher: S. Karger AG

ISSN (Print): 0250-8095

ISSN (Electronic): 1421-9670

Publication date Subscription-year: 1990

Publication date (Print): 1990

Publication date (Electronic): 28 October 2008

Volume: 10

Issue: 5

Pages: 359-362

Affiliations

Departments of ^aMedicine and ^bPathology, University of Saskatchewan, Saskatoon, Sask., Canada

Article

Publisher ID: 168150 Other ID: Am J Nephrol 1990;10:359–362

DOI: 10.1159/000168150

PubMed ID: 2080786

SO-VID: 3c2ad99e-c087-4b5f-b17c-1740a6f6b8ae

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date received : 15 November 1989

Date accepted : 29 March 1990

Page count

Pages: 4

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