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

Low Fractional Excretion of Urine Sodium in Acute Renal Failure due to Sepsis Abstract • A low fractional excretion of sodium (FENa) of less than 1% was present in two patients who had acute renal failure due to sepsis. Both patients had bacteremia and had undergone major abdominal and vascular surgery. Prerenal azotemia due to volume depletion was not present as adequate central filling pressures were maintained with a Swan-Ganz catheter. Interstitial nephritis and obstructive uropathy were carefully ruled out. Acute renal failure due to sepsis should be included among the other conditions recently reported with a low FENa. This is of great importance as errors in fluid management are possible in this high-risk patient population when much reliance is placed on the interpretation of a low FENa of less than 1%. (Arch Intern Med 1983;143:738-739) References 1. Espinel CH, Gregory AW: Differential diagnosis of acute renal failure. Clin Nephrol 1980;13:73-77. 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. Vaz AJ: Subclavian hemodialysis using the two-catheter single-lumen approach. Clin Exp Dialysis Apheresis 1982:6:147-164. 4. Acute renal failure after major surgery, editorial. Br Med J 1980;280: 2-3.Crossref 5. Teschan PE, Baxter CR, O'Brien JN, et al: Prophylactic hemodialysis in the treatment of acute renal failure. Ann Intern Med 1960;53:992.Crossref 6. Oken DE: On the differential diagnosis of acute renal failure. Am J Med 1981;71:916-920.Crossref 7. Miller PD, Krebs RA, Neal BJ, et al: Polyuric prerenal failure. Arch Intern Med 1980;140:907-909.Crossref 8. Diamond JR, Yoburn DC: Nonoliguric acute renal failure associated with a low fractional excretion of sodium. Ann Intern Med 1982;96:597-600.Crossref 9. Vertel RM, Knochel JP: Nonoliguric acute renal failure. JAMA 1967;200:598-602.Crossref 10. Epstein M: Deranged sodium homeostasis in cirrhosis. Gastroenterology 1979;76:622-635. 11. Hilberman M, Myers BD, Carrie BJ, et al: Acute renal failure following cardiac surgery. J Thorac Cardiovasc Surg 1979;77:880-888. 12. Fang LST, Sirota RA, Ebert TH, et al: Low fractional excretion of sodium with contrast media—induced acute renal failure. Arch Intern Med 1980;140:531-533.Crossref 13. Steiner RW: Low fractional excretion of sodium in myoglobinuric renal failure. Arch Intern Med 1982;142:1216-1217.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

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

Archives of Internal Medicine , Volume 143 (4) – Apr 1, 1983

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1983.00350040128017
Publisher site
See Article on Publisher Site

Abstract

Abstract • A low fractional excretion of sodium (FENa) of less than 1% was present in two patients who had acute renal failure due to sepsis. Both patients had bacteremia and had undergone major abdominal and vascular surgery. Prerenal azotemia due to volume depletion was not present as adequate central filling pressures were maintained with a Swan-Ganz catheter. Interstitial nephritis and obstructive uropathy were carefully ruled out. Acute renal failure due to sepsis should be included among the other conditions recently reported with a low FENa. This is of great importance as errors in fluid management are possible in this high-risk patient population when much reliance is placed on the interpretation of a low FENa of less than 1%. (Arch Intern Med 1983;143:738-739) References 1. Espinel CH, Gregory AW: Differential diagnosis of acute renal failure. Clin Nephrol 1980;13:73-77. 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. Vaz AJ: Subclavian hemodialysis using the two-catheter single-lumen approach. Clin Exp Dialysis Apheresis 1982:6:147-164. 4. Acute renal failure after major surgery, editorial. Br Med J 1980;280: 2-3.Crossref 5. Teschan PE, Baxter CR, O'Brien JN, et al: Prophylactic hemodialysis in the treatment of acute renal failure. Ann Intern Med 1960;53:992.Crossref 6. Oken DE: On the differential diagnosis of acute renal failure. Am J Med 1981;71:916-920.Crossref 7. Miller PD, Krebs RA, Neal BJ, et al: Polyuric prerenal failure. Arch Intern Med 1980;140:907-909.Crossref 8. Diamond JR, Yoburn DC: Nonoliguric acute renal failure associated with a low fractional excretion of sodium. Ann Intern Med 1982;96:597-600.Crossref 9. Vertel RM, Knochel JP: Nonoliguric acute renal failure. JAMA 1967;200:598-602.Crossref 10. Epstein M: Deranged sodium homeostasis in cirrhosis. Gastroenterology 1979;76:622-635. 11. Hilberman M, Myers BD, Carrie BJ, et al: Acute renal failure following cardiac surgery. J Thorac Cardiovasc Surg 1979;77:880-888. 12. Fang LST, Sirota RA, Ebert TH, et al: Low fractional excretion of sodium with contrast media—induced acute renal failure. Arch Intern Med 1980;140:531-533.Crossref 13. Steiner RW: Low fractional excretion of sodium in myoglobinuric renal failure. Arch Intern Med 1982;142:1216-1217.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Apr 1, 1983

References