Fractional Excretion Of Sodium
The fractional excretion of sodium is the percentage of the sodium filtered by the kidney which is excreted in the urine. It is measured in terms of plasma and urine sodium rather than by the interpretation of urinary sodium concentration alone as urinary sodium concentrations can vary with water reabsorption.
Utility Of Fractional Excretion Of Urea In The Differential
Fractional excretion of sodium fena utilizes urine chemistry to distinguish between different causes of acute kidney injury aki.
Fractional excretion of sodium. This calculation is widely used to help differentiate prerenal disease decreased renal perfusion from acute tubular necrosis atn as the cause of acute kidney injury aki formerly called acute renal failure. Dehydration however in intrinsic renal failure e g. The fractional excretion of sodium fena measures the percent of filtered sodium that is excreted in the urine.
Therefore the urinary and plasma concentrations of sodium must be compared to get an accurate picture of kidney clearance. Instead it is a calculation based on the concentrations of sodium and creatinine in the blood and urine. Atn ain gn the kidney loses its ability to retain sodium therefore sodium is wasted in the urine cannot be reabsorbed and results in a high fena.
Is it a prerenal cause decreased perfusion acute tubular necrosis atn or a post renal cause obstruction. In acutely azotemic patients a low fractional excretion of sodium usually indicates a prerenal process that is responsive to volume repletion. In most normal subjects the fractional excretion of sodium is usually less than 1 percent but may be raised with an increase in salt intake.
Calculate the fractional excretion of sodium given the serum and urine sodium and the serum and urine creatinine. Fena is greater than 1 and usually greater than 3 with acute tubular necrosis and severe obstruction of the urinary drainage of both kidneys. In clinical use the fractional excretion of sodium can be cal.
The acronym fena derives from fractional excretion and na na is the chemical symbol for sodium. The fractional excretion of sodium fena determines if renal failure is due to pre renal intrinsic or post renal pathology. It is the dedication of healthcare workers that will lead us through this crisis.
To accurately interpret fena patients should not have recently received diuretics. Fractional excretion of sodium fena is not a test. Fractional excretion of sodium is the amount of salt sodium that leaves the body through urine compared to the amount filtered and reabsorbed by the kidney.
Hence the urine sodium excretion fena is reduced in prerenal failure e g. In the setting of acute renal failure a fractional excretion of sodium fe na 1 suggests a prerenal state while a value 1 is suggestive of atn. This is an unprecedented time.
The fena calculation estimates the percentage of sodium filtered by the kidneys that ends up being excreted into the urine. These rules are not absolute however.
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