Abstract

Determining the cause of acutely deteriorating renal function is a common problem in clinical nephrology. The fractional excretion of filtered sodium (FENa) has been demonstrated to be a reliably discriminating test between prerenal azotemia and acute tubular necrosis. However, with increasing clinical use of the FENa, numerous reports of low FENa (less than 1%) have appeared. The clinical settings of these reports include oliguric and nonoliguric acute tubular necrosis, urinary tract obstruction, acute glomerulonephritis, hepatorenal syndrome, renal allograft rejection, sepsis, and drug-related alterations in renal hemodynamics. One particular urinary index cannot be expected to reliably discriminate between prerenal azotemia and acute renal failure in all cases. The utility of the FENa test in the differential diagnosis of acute renal failure must be interpreted in conjunction with the patient's clinical course and the use of additional urinary and serum tests.

Keywords

Fractional excretion of sodiumAcute tubular necrosisMedicineAzotemiaInternal medicineSepsisRenal functionUrologyFurosemideAcute kidney injuryUrinary system

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Publication Info

Year
1985
Type
article
Volume
145
Issue
1
Pages
108-108
Citations
111
Access
Closed

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Stuart Zarich (1985). Fractional Excretion of Sodium. Archives of Internal Medicine , 145 (1) , 108-108. https://doi.org/10.1001/archinte.1985.00360010144022

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DOI
10.1001/archinte.1985.00360010144022