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The fractional excretion of sodium (FE Na) is the percentage of the sodium filtered by the kidney which is excreted in the urine.It is measured in terms of plasma and urine sodium, rather than by the interpretation of urinary sodium concentration alone, as urinary sodium concentrations can vary with water reabsorption.
The urine sodium is expressed as a concentration (such as millimoles per liter). The result must therefore be interpreted in the context of the degree of urine concentration present. Alternatively, the urine sodium can be standardized to the excretion of creatinine using a formula such as the fractional excretion of sodium (FENa).
Urine electrolyte levels can be measured in a medical laboratory for diagnostic purposes. The urine concentrations of sodium , chlorine and potassium may be used to investigate conditions such as abnormal blood electrolyte levels, acute kidney injury , metabolic alkalosis and hypovolemia .
Water and sodium reabsorption is tied to urea reabsorption, so in a prerenal situation, more urea gets reabsorbed into the blood, resulting in a BUN to creatinine ratio of greater than 20:1. More sodium and water being retained in the blood, means that the urine sodium is usually less than 20 mEq/L, that the fraction of sodium excreted to ...
It is defined by an increase in serum creatinine level to >133 μmol/L (1.5 mg/dL) or a creatinine clearance of less than 40 mL/min, and a urine sodium < 10 μmol/L. [7] It also carries a poor outlook, with a median survival of approximately six months unless the affected individual undergoes liver transplantation.
Hyponatremia or hyponatraemia is a low concentration of sodium in the blood. [4] It is generally defined as a sodium concentration of less than 135 mmol/L (135 mEq/L), with severe hyponatremia being below 120 mEq/L. [3] [8] Symptoms can be absent, mild or severe.
It uses Na-H antiport, Na-glucose symport, sodium ion channels (minor). [1] It is stimulated by angiotensin II and aldosterone, and inhibited by atrial natriuretic peptide. It is very efficient, since more than 25,000 mmol/day of sodium is filtered into the nephron, but only ~100 mmol/day, or less than 0.4% remains in the final urine.
Moderate or severe hyponatremia, or hyponatremia with severe symptoms is treated by raising the serum sodium level by 1–2 mmol per liter per hour for the first few hours with a goal of raising levels less than 8–10 mmol per liter in the first 24 hours and 18 mmol per liter in the first 48 hours. [2]