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Low Fractional Excretion of Sodium in Myoglobinuric Renal Failure

Low Fractional Excretion of Sodium in Myoglobinuric Renal Failure Abstract • Two patients with rhabdomyolysis had a low fractional excretion of sodium (FENa) that was verified repeatedly during the oliguric phase of established myoglobinuric renal failure. Volume depletion was ruled out in the first patient by lack of response to a volume challenge and in the second patient by direct hemodynamic monitoring. In both patients, return of renal function was rapid, and dialysis was unnecessary. The finding of a low FENa does not rule out myoglobinuric renal failure or necessarily indicate a volume-responsive component to the reduction in glomerular filtration rate. (Arch Intern Med 1982;142:1216-1217) References 1. Espinel CH: The FENa test. JAMA 1976;236:579-581.Crossref 2. Miller TR, Anderson RJ, Linas SL, et al: Urinary diagnostic indices in acute renal failure: A prospective study. Ann Intern Med 1978;89:47-50.Crossref 3. Hamilton RW, Gardner LB, Penn AS, et al: Acute tubular necrosis caused by exercise-induced myoglobinuria. Ann Intern Med 1972;77:77-82.Crossref 4. Grossman RA, Hamilton RW, Morse BM, et al: Nontraumatic rhabdomyolysis and acute renal failure. N Engl J Med 1974;291:807-811.Crossref 5. DeWardener HE: The control of sodium excretion. Am J Physiol 1978;235:163-173. 6. Pru C, Kjellstrand C: The clinical usefulness of the FENa test. Read before the American Society of Nephrology's 13th annual meeting, Washington, DC, Nov 23-25, 1980. 7. Danovitch GM, Bourgoigne J, Bricker NS: Reversibility of the 'salt losing' tendency of chronic renal failure. N Engl J Med 1977;296:14-19.Crossref 8. Fang LST, Sirota RA, Ebert TA, et al: Low fractional excretion of sodium with contrast media-induced acute renal failure. Arch Intern Med 1980;140:531-533.Crossref 9. Knochel JP: Environmental illness: An eclectic review. Arch Intern Med 1974;133:341-384.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Low Fractional Excretion of Sodium in Myoglobinuric Renal Failure

Archives of Internal Medicine , Volume 142 (6) – Jun 1, 1982

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340190172029
Publisher site
See Article on Publisher Site

Abstract

Abstract • Two patients with rhabdomyolysis had a low fractional excretion of sodium (FENa) that was verified repeatedly during the oliguric phase of established myoglobinuric renal failure. Volume depletion was ruled out in the first patient by lack of response to a volume challenge and in the second patient by direct hemodynamic monitoring. In both patients, return of renal function was rapid, and dialysis was unnecessary. The finding of a low FENa does not rule out myoglobinuric renal failure or necessarily indicate a volume-responsive component to the reduction in glomerular filtration rate. (Arch Intern Med 1982;142:1216-1217) References 1. Espinel CH: The FENa test. JAMA 1976;236:579-581.Crossref 2. Miller TR, Anderson RJ, Linas SL, et al: Urinary diagnostic indices in acute renal failure: A prospective study. Ann Intern Med 1978;89:47-50.Crossref 3. Hamilton RW, Gardner LB, Penn AS, et al: Acute tubular necrosis caused by exercise-induced myoglobinuria. Ann Intern Med 1972;77:77-82.Crossref 4. Grossman RA, Hamilton RW, Morse BM, et al: Nontraumatic rhabdomyolysis and acute renal failure. N Engl J Med 1974;291:807-811.Crossref 5. DeWardener HE: The control of sodium excretion. Am J Physiol 1978;235:163-173. 6. Pru C, Kjellstrand C: The clinical usefulness of the FENa test. Read before the American Society of Nephrology's 13th annual meeting, Washington, DC, Nov 23-25, 1980. 7. Danovitch GM, Bourgoigne J, Bricker NS: Reversibility of the 'salt losing' tendency of chronic renal failure. N Engl J Med 1977;296:14-19.Crossref 8. Fang LST, Sirota RA, Ebert TA, et al: Low fractional excretion of sodium with contrast media-induced acute renal failure. Arch Intern Med 1980;140:531-533.Crossref 9. Knochel JP: Environmental illness: An eclectic review. Arch Intern Med 1974;133:341-384.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jun 1, 1982

References