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If this gap falls within an acceptable range,(<10) then it is assumed that sodium, glucose, BUN are indeed the major dissolved ions and molecules in the serum. If, however, the calculated gap is above an acceptable range, then it is an indication that there is something else dissolved in the serum that is producing an osmol gap, which can be a ...
Urine osmolality in humans can range from approximately 50 to 1200 mOsm/kg, depending on whether the person has recently drunk a large quantity of water (the lower number) or has gone without water for a long time (the higher number). [2] Plasma osmolality with typical fluid intake often averages approximately 290 mOsm/kg H 2 O in humans. [2]
Urine NH 4 + 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 NH 4 + excretion. In a metabolic acidosis without a serum anion gap: A positive urine anion gap suggests a low urinary NH 4 + (e.g. renal tubular acidosis).
The anion gap is the quantity difference between cations (positively charged ions) and anions (negatively charged ions) in serum, plasma, or urine. The magnitude of this difference (i.e., "gap") in the serum is calculated to identify metabolic acidosis .
The resulting "osmolar gap" can be thought of as either osmolar or osmolal, since both units have been used in its derivation. [ citation needed ] Measured osmolality is abbreviated "MO", calculated osmolarity is abbreviated "CO", and the osmolality gap is abbreviated "OG".
How rapidly the kidney clears the blood plasma of a substance (be it water or solute) is the renal clearance, which is related to the rate of urine production. The rate at which plasma is cleared of solute is the osmolal clearance; the rate at which plasma is cleared of solute-free water is the free water clearance.
The anion gap (AG) without potassium is calculated first and if a metabolic acidosis is present, results in either a high anion gap metabolic acidosis (HAGMA) or a normal anion gap acidosis (NAGMA). A low anion gap is usually an oddity of measurement, rather than a clinical concern.
High anion gap metabolic acidosis is typically caused by acid produced by the body. More rarely, it may be caused by ingesting methanol or overdosing on aspirin . [ 1 ] [ 2 ] The delta ratio is a formula that can be used to assess elevated anion gap metabolic acidosis and to evaluate whether mixed acid base disorder (metabolic acidosis) is present.