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Interpretation of the Fractional Excretion of Sodium in the Absence of Acute
Kidney Injury: A Cross-Sectional Study
#MMPMID28391266
Schreuder MF
; Bökenkamp A
; van Wijk JAE
Nephron
2017[]; 136
(3
): 221-225
PMID28391266
show ga
BACKGROUND/AIMS: The fractional excretion of sodium (FeNa) may be helpful in
establishing the cause of acute renal failure. This study was performed to
determine the influence of the glomerular filtration rate (GFR), sodium intake,
and tubular function on FeNa in children without renal failure. METHODS: In this
single institute cross-sectional study, 24-h-urine collections from patients
(4-18 years of age, GFR >60 mL/min/1.73 m2) were used when considered reliable,
and analyzed to determine sodium excretion, creatinine clearance and FeNa. The
influence of tubular function was studied in 5 patients with generalized tubular
dysfunction. RESULTS: Based on data from 761 patients, a multiple regression
formula was designed based on GFR and sodium excretion that predicted over 80% of
the variation in FeNa (R2 = 0.824, p < 0.001). Using this formula, the predicted
FeNa was significantly lower than the measured FeNa in the children with tubular
dysfunction. CONCLUSION: FeNa depends on GFR and sodium intake, and tubular
function cannot be assessed without possessing adequate knowledge on all factors.
Therefore, no normal range or cut-off value for FeNa to assess tubular function
can be given, and doing so is a misapplication of this equation.
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