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Joel M. Topf, MD FACP Profile picture
Joel M. Topf, MD FACP
@kidney_boy
Saying the product of the kidneys is urine is like saying the product of a factory is pollution. Urine is a by-product. The product is homeostasis COI: link👇🏼

Apr 9, 2022, 7 tweets

Next up is Dr. Uribarri to savage the urinary anion gap. Sorry @Dan_Batlle.

The urine anion gap is not real, but allows you to see what is not measured. There is no gap. Cations must equal anions.

Since 24 urine Na, K, Cl equal their dietary intake, then the urine anion gap must reflect relative dietary intake not ammonia in the urine. #NKFClinicals

And here is the data. #NKFClinicals

Hey Siri, show me a scatter plot. No relationship between urine anion gap and urine NH4. N=24,000. #NKFClinicals

Says the source of the early data showing the success of urine anion gap was the administration of ammonium chloride which directly increased the urine chloride which made the urine anion gap more negative. #NKFClinicals

Brilliant and convincing presentation. #NKFClinicals

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