Urine Anion Gap in NAGMA NA + K - Cl = surrogate for Urine NH4+ NH4+ is excreted with Cl- as counter-ion, hence increasing negative AG implies ↑ ammonium. NEGATIVE when the distal acidification is intact: - All GI distrubances - Proximal RTA POSITIVE when urinary NH4+ excretion imparied: - Distal RTA - Type 4 RTA (nb ↑K) - Renal Failure Dr. John Booth @ThePeanutKidney #Urine #AnionGap #NAGMA #diagnosis #differential #Urinary
