Assessing urine ammonium concentration by urine osmolal gap in chronic kidney disease
Assessing urine ammonium concentration by urine osmolal gap in chronic kidney disease
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DOI：
10.1111/nep.13937
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发表时间：
2021-07-20
期刊：
影响因子：
2.5
通讯作者：
Komatsu, Yasuhiro
中科院分区：
文献类型：
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作者：
Fujimaru, Takuya;Shuo, Takuya;Komatsu, Yasuhiro
酸血症是终末期肾病的危险因素之一，会增加慢性肾病（CKD）患者的死亡率。尽管尿铵 (U-NH4+) 是肾脏酸排泄的重要组成部分，但并不常规测量 U-NH4+ 浓度。为了估计 U-NH4+，需要计算尿渗透压间隙（UOG = 尿渗透压 - [2(Na+ + K+) + 尿素 + 葡萄糖]），传统上使用公式 (U-NH4+ = UOG/2)。然而，该配方对于 CKD 患者的有效性存在争议。我们评估了 CKD 患者中 U-NH4+ 与 UOG 之间的关系。收集了 36 名非透析依赖性 CKD 患者的血液和点尿样本。患者的平均+/- SD年龄为72.0 +/- 14.8岁，平均+/- SD血清肌酐和U-NH4+分别为2.7 +/- 2.3 mg/dl和9.3 +/- 9.2 mmol/L。 UOG/2 和 U-NH4+ 之间存在显着关系 (r = .925，p < .0001)。使用 UOG 估算的 U-NH4+ 平均比测量值高 4.7 mmol/L。我们的结果表明，UOG 可能是临床环境中的有用工具，特别是对于中度至重度 CKD 患者。
Acidemia is one of the risk factors for end-stage kidney disease and increases the mortality rate of patients with chronic kidney disease (CKD). Although urinary ammonium (U-NH4+) is the crucial component of renal acid excretion, U-NH4+ concentration is not routinely measured. To estimate U-NH4+, urine osmolal gap (UOG = urine osmolality - [2(Na+ + K+) + urea + glucose]) is calculated and the formula (U-NH4+ = UOG/2) has traditionally been used. However, the usefulness of this formula is controversial in CKD patients. We assessed the relationship between U-NH4+ and UOG in patients with CKD. Blood and spot urine samples were collected in 36 patients who had non-dialysis-dependent CKD. The mean +/- SD age of patients was 72.0 +/- 14.8 years, and the mean +/- SD serum creatinine and U-NH4+ were 2.7 +/- 2.3 mg/dl and 9.3 +/- 9.2 mmol/L, respectively. A significant relationship was found between UOG/2 and U-NH4+ (r = .925, p < .0001). U-NH4+ estimated using the UOG was on average higher by 4.7 mmol/L than the measured one. Our results suggested that UOG could be a useful tool in clinical settings, especially in patients with moderate to severe CKD.