Low Fractional Excretion of Urine Sodium in Acute Renal Failure due to Sepsis

Vaz, Anthony J.

doi:10.1001/archinte.1983.00350040128017

Cited by 58 publications

(16 citation statements)

References 11 publications

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“…Several other forms of ARF associated with a low Na excretion rate have been suggested, including sepsis [20], rhabdomyolysis [21], and more commonly, intravenous radiocontrast infusion [8][9][10][11]. In general, our study did not confirm these results.…”

Section: Discussioncontrasting

confidence: 88%

Low Fractional Excretion of Sodium in Acute Renal Failure: Role of Timing of the Test and Ischemia

Brosius

Lau

1986

Am J Nephrol

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To evaluate the mechanisms for a low fractional excretion of Na (FENa ≤ 1.0) in acute renal failure (ARF) of a sustained nature, causes were determined independent of FENa in 41 patients without volume depletion, obstruction, vasculitis or glomerulonephritis. The 16 patients (39%) with low FENa had lower incidence of preexisting azotemia, lower peak serum creatinine, but higher incidence of renal ischemia and earlier testing (by 1.7 days). Seven often such patients converted to high FENa on repeat, whereas FENa remained high in 15 of 17 patients with initially high values. The initial FENa was a direct function of time from the onset of ARF. Low FENa in acute but sustained renal failure is therefore best explained by (1) milder insults; (2) earlier determinations, and/or (3) superimposed renal ischemia.

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Section: Discussioncontrasting

confidence: 88%

Low Fractional Excretion of Sodium in Acute Renal Failure: Role of Timing of the Test and Ischemia

Brosius

Lau

1986

Am J Nephrol

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“…In addition, it is also well known that patients with multiple organ failure in septic shock have a very poor outcome, both in terms of renal functional recovery and patient survival [1,3,[13][14][15]. Our 4 patients with ARF, on the other hand, seemed to be in an early stage of ARF and only 3 required dialytic support.…”

Section: Discussionmentioning

confidence: 78%

Effects of Naloxone Infusion in Patients with Septic Shock and Renal Failure: A Limited Experience

Duarte

Ali²,

Sayegh³

et al. 1992

Am J Nephrol

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Septic shock is frequently associated with acute renal failure. Management of these patients becomes complicated if either the renal or systemic hemodynamic derangement cannot be corrected. Although previously large doses of furosemide and naloxone infusion have been used separately in managing these patients, the combination of both agents has not been employed. We therefore report our limited experience with this combined treatment in 5 patients with septic shock, of which 4 had acute renal failure.

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“…24 or tubular function [25][26][27][28][29] which can result in an altered renal handling of sodium. [30][31][32][33][34][35][36]101 Surprisingly, while use of diuretics are well known to make the FeNa unreliable, [35][36][37][38] other drugs, such as amphotericin, that are known to cause proximal tubular damage may not.…”

Section: Ureamentioning

confidence: 99%

Toward the optimal clinical use of the fraction excretion of solutes in oliguric azotemia

et al. 2010

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While the fractional excretion of solutes have long been considered excellent research tools to investigate tubular physiology, their clinical use has become common over the last 40 years in the diagnoses of many disorders; however, none have reached the clinical utility of the fractional excretion of sodium in the ability to distinguish pre-renal azotemia from acute tubular necrosis. Nevertheless, there are many drugs and medical conditions that interfere with that utility and recently other solutes, including urea, uric acid and lithium, have been recently investigated to improve the diagnostic ability in clinical situations where the fractional excretion of sodium is known to be unreliable. We review the tubular physiology of these solutes and show how the differences in tubular physiology might be exploited to develop a strategy for their optimal clinical use.

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Low Fractional Excretion of Urine Sodium in Acute Renal Failure due to Sepsis

Cited by 58 publications

References 11 publications

Low Fractional Excretion of Sodium in Acute Renal Failure: Role of Timing of the Test and Ischemia

Low Fractional Excretion of Sodium in Acute Renal Failure: Role of Timing of the Test and Ischemia

Effects of Naloxone Infusion in Patients with Septic Shock and Renal Failure: A Limited Experience

Toward the optimal clinical use of the fraction excretion of solutes in oliguric azotemia

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