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Title of Journal: Pediatr Nephrol

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Abbravation: Pediatric Nephrology

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Springer Berlin Heidelberg

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DOI

10.1002/hlca.193902201183

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1432-198X

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Utility of fractional excretion of urea in the dif

Authors: Hisayo Fujita Masayoshi Shinjoh Tomohiro Ishii Midori Awazu
Publish Date: 2016/03/18
Volume: 31, Issue: 8, Pages: 1349-1353
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Abstract

The fractional excretion of sodium FENa has been used as an index for the differential diagnosis of acute tubular necrosis ATN and prerenal acute kidney injury AKI The reliability of this index however decreases with the use of the diuretic agent furosemide The fractional excretion of urea nitrogen FEUN has been shown to be useful in such settings in adults The objective of this study was to examine whether FEUN is also useful in these settings in childrenWe assessed 102 episodes of AKI in 74 children classifying these into three groups based on history physical examination urine examination and subsequent clinical course 1 prerenal AKI without furosemide N = 37 2 prerenal AKI with furosemide N = 32 and 3 ATN N = 33Of the 37 prerenal AKI episodes without furosemide 35 showed low FENa of 1  with an overall average of 035 ± 011  whereas prerenal AKI with furosemide 163 ± 037  and ATN 876 ± 211  were associated with a higher FENa FEUN in the clinical setting of prerenal AKI was lower than that in ATN 279 ± 21 vs 516 ± 38  respectively and in contrast to FENa not significantly different between the categories of prerenal AKI with and without furosemide 292 ± 31 vs 251 ± 29 respectively The sensitivity of FEUN 35  was 75  in prerenal AKI with furosemide whereas that of FENa was 53 

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