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The Use of Bedside Urinary Parameters in the Evaluation of Metabolic Acidosis

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Metabolic Acidosis

Abstract

The evaluation of metabolic acidosis requires an assessment of the kidneys response in terms of acid excretion and bicarbonate excretion. Because of bedside measurements of ammonium excretion and bicarbonate are often not available because clinical laboratories do not perform these tests routinely, surrogates like the urine anion gap were developed as an indirect measure of the ammonium excretion. Bicarbonate can be calculated based on the urine pH and PCO2 of the urine. The significance and limitations of the urine pH as an index of collecting tubule H+ secretion as discussed. Moreover, the use of provocative tests such as the furosemide test as a tool to assess sodium dependent collecting tubule H+ secretion is also discussed.

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, 320 E. Superior, Chicago, IL, 60611, USA

    Daniel Batlle M.D. & Nitin Relia M.D.

  2. Department of Nephrology, Northwestern Memorial Hospital, 710 North Fairbanks Court Suite 4-500, Chicago, IL, 60611, USA

    Khurram Saleem M.D.

Authors
  1. Daniel Batlle M.D.
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  2. Khurram Saleem M.D.
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  3. Nitin Relia M.D.
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Corresponding author

Correspondence to Khurram Saleem M.D. .

Editor information

Editors and Affiliations

  1. Baylor Scott & WhiteHealth Dept Int Med., Texas A&M Health Sci. Cent. Collg of Med, Temple, Texas, USA

    Donald E. Wesson

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Batlle, D., Saleem, K., Relia, N. (2016). The Use of Bedside Urinary Parameters in the Evaluation of Metabolic Acidosis. In: E. Wesson, D. (eds) Metabolic Acidosis. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3463-8_5

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  • DOI: https://doi.org/10.1007/978-1-4939-3463-8_5

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