Urine Anion Gap Calculator

Calculate urine anion gap to assess kidney acid excretion and diagnose metabolic acidosis

Calculate Urine Anion Gap

24-hour urine collection preferred for accuracy

Major cation in urine along with sodium

Major anion in urine, often accompanies ammonium

Example Calculations

Normal Response (Diarrhea)

Urine values: Na⁺ 40 mEq/L, K⁺ 25 mEq/L, Cl⁻ 80 mEq/L

Calculation: 40 + 25 - 80 = -15 mEq/L

Interpretation: Negative UAG indicates high NH₄⁺ excretion (appropriate kidney response)

Renal Tubular Acidosis

Urine values: Na⁺ 60 mEq/L, K⁺ 30 mEq/L, Cl⁻ 45 mEq/L

Calculation: 60 + 30 - 45 = +45 mEq/L

Interpretation: Positive UAG suggests impaired NH₄⁺ excretion (possible RTA)

Reference Ranges

Normal UAG

0 to +10 mEq/L

(Sometimes -10 to +20 mEq/L)

Negative UAG

< 0 mEq/L

High NH₄⁺ excretion

Positive UAG

> +10 mEq/L

Low NH₄⁺ excretion

Clinical Applications

Metabolic Acidosis

Differential diagnosis of non-anion gap metabolic acidosis

Kidney Function

Assessment of renal acid excretion capacity

RTA Diagnosis

Screening for renal tubular acidosis

Ammonium Assessment

Indirect measurement of urinary NH₄⁺

Associated Conditions

Negative UAG

  • • Diarrhea
  • • Ureterosigmoidostomy
  • • Carbonic anhydrase inhibitors
  • • Normal kidney response

Positive UAG

  • • Type 1 RTA (distal)
  • • Type 4 RTA (hyperkalemic)
  • • Chronic kidney disease
  • • Aldosterone deficiency

Understanding Urine Anion Gap

What is Urine Anion Gap?

The urine anion gap (UAG) is a calculated value that estimates unmeasured ions in urine, primarily ammonium (NH₄⁺). It's used to assess the kidney's ability to excrete acid and helps differentiate causes of metabolic acidosis.

Clinical Significance

  • Differentiates renal vs. non-renal causes of metabolic acidosis
  • Assesses kidney's acid excretion function
  • Screens for renal tubular acidosis
  • Indirectly measures urinary ammonium

Formula & Physiology

UAG = [Na⁺] + [K⁺] - [Cl⁻]

Na⁺ & K⁺: Major measured cations in urine
Cl⁻: Major measured anion in urine
NH₄⁺: Major unmeasured cation (accompanies Cl⁻)

Interpretation

Negative UAG: High NH₄⁺ excretion (normal response)
Positive UAG: Low NH₄⁺ excretion (impaired function)
Normal UAG: Appropriate acid-base balance