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FENa Calculator

Calculate Fractional Excretion of Sodium to differentiate causes of acute kidney injury

Calculate FENa

Normal: 0.6-1.2 mg/dL (men), 0.5-1.1 mg/dL (women)

Normal: 135-145 mmol/L

Varies widely; typically 20-370 mg/dL

Normal: 100-260 mmol/L per 24 hours

FENa Reference Ranges

Prerenal

<1%

Decreased renal perfusion

Intrinsic

1-4%

Intrinsic kidney damage

Postrenal

>4%

Urinary tract obstruction

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Required Lab Tests

1

Blood Tests

Serum creatinine and sodium

2

Urine Tests

Urine creatinine and sodium

Random or 24-hour collection

When to Use FENa

Acute kidney injury evaluation

Oliguria or anuria workup

Differentiating AKI causes

Patients on diuretics

Chronic kidney disease

Example Calculation

Sample Values

Plasma Cr: 2.0 mg/dL

Plasma Na: 140 mmol/L

Urine Cr: 80 mg/dL

Urine Na: 15 mmol/L

Calculation

FENa = (2.0 × 15) / (140 × 80) × 100

FENa = 30 / 11,200 × 100

FENa = 0.27%

Result: Prerenal cause

Understanding FENa (Fractional Excretion of Sodium)

What is FENa?

FENa represents the percentage of filtered sodium that is excreted in the urine. It's a valuable tool for differentiating the causes of acute kidney injury by assessing how well the kidneys are conserving sodium in response to decreased perfusion or intrinsic damage.

Clinical Significance

  • Helps distinguish prerenal from intrinsic AKI
  • Guides appropriate treatment strategies
  • Assists in prognosis assessment
  • Valuable in critical care settings

Formula Explanation

FENa = (PCr × UNa) / (PNa × UCr) × 100

  • PCr: Plasma creatinine concentration
  • UNa: Urine sodium concentration
  • PNa: Plasma sodium concentration
  • UCr: Urine creatinine concentration

Physiological Basis: In prerenal AKI, the kidneys retain their ability to conserve sodium, resulting in low FENa. In intrinsic AKI, this ability is impaired, leading to higher FENa values.

⚠️ Important Medical Disclaimer

This calculator is for educational purposes only and should not replace professional medical advice.

  • • Always consult with a qualified nephrologist or physician for AKI evaluation
  • • FENa should be interpreted within the full clinical context
  • • Consider other diagnostic tests and clinical findings
  • • Monitor patient closely and adjust treatment based on response
  • • Be aware of the limitations of FENa in certain clinical scenarios
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