DIFFERENTIAL-DIAGNOSIS OF ACUTE-RENAL-FAILURE

  • 1 January 1980
    • journal article
    • research article
    • Vol. 13  (2) , 73-77
Abstract
This prospective study compares the fractional excretion of Na FENa, urinary Na concentration, UNa, urine osmolality, Uosm, and the U/P creatinine ratio in their diagnostic effectiveness in 87 patients with acute renal failure: 22 acute tubular necrosis, 18 non-oliguric acute tubular necrosis, 12 acute urinary tract obstruction, 14 acute glomerulonephritis and 21 pre-renal azotemia. Discriminant analysis demonstrated a correct diagnostic classification in 86 of 87 patients using FENa, and only 46, 60 and 65 correct using Uosm, UNa and U/P Cr, respectively. FENa is identified as the most effective non-invasive test for the differential diagnosis of acute renal failure. An FENa of 1 classifies all entities into 2 groups: FENa more than 1; acute tubular necrosis, non-oliguric acute tubular necrosis and urinary tract obstruction and less than 1; pre-renal azotemia and acute glomerulonephritis (P < 0.001).

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