Doctors can often see a large hiatus hernia on a chest x-ray. Otherwise, people are given barium in a liquid before x-rays are taken (barium swallow). The barium outlines the esophagus, making abnormalities easier to see. Hernias can also be seen during an upper endoscopy.
The kidneys filter the blood to remove wastes and produce urine. The ureters, urinary bladder, and urethra together form the urinary tract, which acts as a plumbing system to drain urine from the kidneys, store it, and then release it during urination.
Excretion of ammonium - type 4 renal tubular acidosis. 1  In type 4 RTA, the key defect is impaired ammoniagenesis. The kidneys produce and excrete ammonia to buffer acid. The normal renal response to metabolic acidosis is the generation of additonal ammonia (NH3) which buffers acid (H+) to form ammonium (NH4+). This is a critical mechanism to eliminate acid and without this buffering, the excretion of the daily load of acid would result in a urine pH of below 3.