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KMID : 0378019810240090066
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New Medical Journal
1981 Volume.24 No. 9 p.66 ~ p.74
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Urinary Diagnostic Indices in Acute Renal Failure
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Abstract
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Twenty nine cases of acute renal failure were prospectively studied to evaluate the effectiveness of renal failure index and FENa, in comparison with urinary sodium concentration, urine osmolality, urine/plasma osmolality ratio, urine/plasma creatinine ratio, in their early differentiation of established acute tubular necrosis from potentially reversible prerenal azotemia.
Mean urinary sodium concentration for patients with acute tubular necrosis was 85 mEq/L and for prerenal azotemia was 38mEq/L, whereas mean urine/plasma creatinine ratio for patients with acute tubular necrosis was 8 and for prerenal azotemia was 28 (p<0.001). Mean urine osmolality and urine/plasma osmolality ratio were somewhat higher in patients with prerenal azotemia but showed no statistical difference. Mean renal failure index and FENa for patients with acute tubular necrosis was 11.27, 14.86 and for prerenal azotemia was 1. 10, 1.46 respectively (p<0.001). Although mean urinary sodium concentration and mean urine/plasma creatinine ratio showed a statistically significant difference, both indices all too often fail to diffentiate acute tubular necrosis from prerenal azotemia in every case because of the substantial overlap between the two groups. In contrast, renal failure index and FENa were identified as the most effective tests in differentiating acute tubular necrosis from prerenal azotemia, clearly classifying these groups into two by the value of 3 with only one exception in each test.
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