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Fractional Excretion of Sodium

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1. Fractional Excretion of Sodium (FENa): Diagnostic Godsend or Gimmick?

Fractional Excretion of Sodium (FENa): Diagnostic Godsend or Gimmick? Fractional Excretion of Sodium (FENa): Diagnostic Godsend or Gimmick? – Clinical Correlations Search Fractional Excretion of Sodium (FENa): Diagnostic Godsend or Gimmick? September 5, 2012 7 min read By Jon-Emile S Kenny, MD Faculty Peer Reviwed A 62- year-old man with a history of hypertension, diastolic dysfunction and chronic kidney disease is admitted 4 days after beginning outpatient treatment of community acquired (...) out if this is pre-renal or a renal problem…do a FENa…if it’s less than 1%, start fluid resuscitating him.’ I nod my head and send the intern for the patient’s urine unquestioningly. After rounds, I wait at the computer for the results and ponder this ‘fractional excretion of sodium.’ What is a normal FENa? In plain-speak, the FENa, or fractional excretion of sodium, is the amount of sodium excreted in the urine out of all the sodium filtered at the glomerulus. It seems like the kidneys

2012 Clinical Correlations

2. Interpretation of the Fractional Excretion of Sodium in the Absence of Acute Kidney Injury: A Cross-Sectional Study Full Text available with Trip Pro

Interpretation of the Fractional Excretion of Sodium in the Absence of Acute Kidney Injury: A Cross-Sectional Study The fractional excretion of sodium (FeNa) may be helpful in establishing the cause of acute renal failure. This study was performed to determine the influence of the glomerular filtration rate (GFR), sodium intake, and tubular function on FeNa in children without renal failure.In this single institute cross-sectional study, 24-h-urine collections from patients (4-18 years of age (...) , GFR >60 mL/min/1.73 m2) were used when considered reliable, and analyzed to determine sodium excretion, creatinine clearance and FeNa. The influence of tubular function was studied in 5 patients with generalized tubular dysfunction.Based on data from 761 patients, a multiple regression formula was designed based on GFR and sodium excretion that predicted over 80% of the variation in FeNa (R2 = 0.824, p < 0.001). Using this formula, the predicted FeNa was significantly lower than the measured FeNa

2017 Nephron. Clinical practice

3. Fractional Excretion of Sodium

Fractional Excretion of Sodium Fractional Excretion of Sodium Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fractional Excretion (...) of Sodium Fractional Excretion of Sodium Aka: Fractional Excretion of Sodium , FENa II. Indications Assessment Prerenal III. Calculation FENa = ( Excretion x 100)/(total filtered load) Excretion = ( ) / ( ) Total filtered Load = ( ) / ( ) FENa = (uNa x sCr x 100) / (sNa x uCr) uNa is sCr is sNa is uCr is IV. Interpretation: Fractional Excretion of Sodium FENa <1%: Prerenal Consistent with spot <30 meq/L FENa >1-2%: Acute Intrinsic renal condition (e.g. ) Consistent with spot >30 meq/L FENa >4%: Post

2018 FP Notebook

4. The Short-Term Effects of Roux-en-Y Gastric Bypass on Renal Excretion of Sodium and Its Association with Blood Pressure. (Abstract)

with body mass index (BMI) of 44.54 ± 7.81 kg/m2 who underwent gastric bypass. Before surgery and at the third and sixth months after gastric bypass, blood pressure, urinary sodium concentration, 24-hour (24-h) urinary sodium excretion, and fractional excretion of sodium were evaluated. In addition, serum sodium and potassium levels were determined. Nonparametric tests were used to analyze the data.Blood pressure decreased after surgery and remained at low levels over the 3- and 6-month periods (...) . The urinary sodium concentration increased at 3 months after surgery; however, the 24-h urinary sodium excretion and urine volume decreased. Interestingly, although some associations between variables were observed, significant correlations between the 24-h urinary sodium excretion and the systolic, diastolic, and mean blood pressures were found. In addition, the urine volume was higher in the sixth month than in the third month following surgery.In the months immediately following surgery, a low-salt

2019 Obesity Surgery

5. Fractional excretion of electrolytes in volume‐responsive and intrinsic acute kidney injury in dogs: Diagnostic and prognostic implications Full Text available with Trip Pro

Fractional excretion of electrolytes in volume‐responsive and intrinsic acute kidney injury in dogs: Diagnostic and prognostic implications The value of fractional excretion (FE) of electrolytes to characterize and prognosticate acute kidney injury (AKI) is poorly documented in dogs.To evaluate the diagnostic and prognostic roles of FE of electrolytes in dogs with AKI.Dogs (n = 135) with AKI treated with standard care (February 2014-December 2016).Prospective study. Clinical and laboratory (...) ), and urinary output (HR = 5.06, P < .001).Fractional excretion of electrolytes performed well in the early differentiation between VR-AKI and I-AKI, were related to outcome, and could be useful tools to manage AKI dogs in clinical practice.Copyright © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

2018 Journal of Veterinary Internal Medicine

6. Effect of sodium nitrite on renal function, sodium and water excretion and brachial and central blood pressure in healthy subjects. A dose-response study. Full Text available with Trip Pro

NaNO2·kg-1·h-1 for 2 h in 12 healthy subjects, after 4 days of a standard diet. Subjects were supine and water loaded. We measured brachial and central blood pressure (BP), plasma concentrations of renin, angiotensin II, aldosterone, arginine vasopressin (P-AVP), and plasma nitrite (P-[Formula: see text]), GFR by Cr-EDTA clearance, fractional excretion of sodium (FENa) free water clearance (CH2O), and urinary excretion rate of guanosine 3',5'-cyclic monophosphate (U-cGMP). The highest dose reduced (...) Effect of sodium nitrite on renal function, sodium and water excretion and brachial and central blood pressure in healthy subjects. A dose-response study. Sodium nitrite (NaNO2) is converted to nitric oxide (NO) in vivo and has vasodilatory and natriuretic effects. Our aim was to examine the effects of NaNO2 on hemodynamics, sodium excretion, and glomerular filtration rate (GFR). In a single-blinded, placebo-controlled, crossover study, we infused placebo (0.9% NaCl) or 0.58, 1.74, or 3.48 μmol

2017 American Journal of Physiology. Renal physiology Controlled trial quality: uncertain

7. Study of Excretion Balance and Pharmacokinetics of [14C]-Sodium Valproate (3.7 MBq) in Healthy Postmenopausal or Permanently Sterile Female Subjects

reconstituted with water Route of administration: Oral Other Name: LA40220 Outcome Measures Go to Primary Outcome Measures : Percentage of radioactive dose excreted in urine and feces [ Time Frame: Day 1 to Day 43 ] Fractional and cumulative percentage of radioactive dose excreted in urine and feces Assessment of key metabolite(s) of sodium valproate [ Time Frame: Day 1 to Day 43 ] key metabolite(s) of sodium valproate will be assessed in plasma, urine and feces. Assessment of PK parameters: Cmax [ Time (...) Study of Excretion Balance and Pharmacokinetics of [14C]-Sodium Valproate (3.7 MBq) in Healthy Postmenopausal or Permanently Sterile Female Subjects Study of Excretion Balance and Pharmacokinetics of [14C]-Sodium Valproate (3.7 MBq) in Healthy Postmenopausal or Permanently Sterile Female Subjects - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved

2018 Clinical Trials

8. Low sodium status in cystic fibrosis-as assessed by calculating fractional Na<sup>+</sup> excretion-is associated with decreased growth parameters. Full Text available with Trip Pro

Low sodium status in cystic fibrosis-as assessed by calculating fractional Na+ excretion-is associated with decreased growth parameters. In CF infants, normonatremic Na(+) depletion (NNaD), identified by fractional Na(+) excretion (FENa) values <0.5%, was recently linked to impaired growth. Our paper investigates the relationship between FENa and growth in CF children >2years.FENa values were calculated in 35 CF and 24 control children, and tested for correlations with z-scores

2016 Journal of Cystic Fibrosis

9. Fractional excretion of sodium in hepatorenal syndrome: Clinical and pathological correlation Full Text available with Trip Pro

Fractional excretion of sodium in hepatorenal syndrome: Clinical and pathological correlation To determine the accuracy of fractional excretion of sodium (FeNa) in the diagnosis of hepatorenal syndrome (HRS).Eighty-eight liver transplantation candidates with renal dysfunction and/or proteinuria were included in the study sample. The baseline characteristics of the patients were obtained. All the 88 patients underwent iothalamate glomerular filtration rate testing, 24-h urine collection (...) for urinary sodium and protein excretions, random urine for sodium and creatinine testing, and percutaneous kidney biopsy. FeNa was calculated using the equation [(urine sodium × serum creatinine)/(serum sodium × urine creatinine)] × 100%. Diuretic use was recorded among the participants. Patients on renal replacement therapy were not included in the original sample.Seventy-seven (87%) of the 88 patients had FeNa < 1%. FeNa < 1% was present in 10/10, 10/12, 11/13, 12/15 and 34/38 in patients with HRS

2016 World journal of hepatology

10. Effect of Fenoldopam Continuous Infusion on Glomerular Filtration Rate and Fractional Excretion of Sodium in Healthy Dogs Full Text available with Trip Pro

Effect of Fenoldopam Continuous Infusion on Glomerular Filtration Rate and Fractional Excretion of Sodium in Healthy Dogs Acute kidney injury (AKI) is a common problem in small-animal patients and carries a guarded prognosis with substantial morbidity and mortality, particularly in oligoanuric dogs. Fenoldopam, a selective dopamine agonist, has been shown to increase urine output in healthy dogs and cats; however, the mechanism of action is unknown.To evaluate the effect of fenoldopam infusion (...) on glomerular filtration rate (GFR) and fractional excretion of sodium (FeNa) in healthy dogs.Ten healthy, privately owned dogs.Randomized, crossover design with negative control. Ten healthy dogs were given fenoldopam diluted in 5% dextrose (D5W) as a continuous IV infusion of 0.8 μg/kg/min for 5 hours and a control infusion of D5W alone, 7 days apart. Glomerular filtration rate was measured by exogenous iohexol clearance, beginning 1 hour after the start of the fenoldopam infusion. Fractional excretion

2016 Journal of Veterinary Internal Medicine Controlled trial quality: uncertain

11. Fractional Excretion of Sodium and Its Association with Prognosis of Decompensated Heart Failure Patients Full Text available with Trip Pro

Fractional Excretion of Sodium and Its Association with Prognosis of Decompensated Heart Failure Patients Diuretic resistance is a common problem in congestive heart failure patients. It has been defined clinically but can be defined objectively in terms of fractional excretion of sodium (FENa).Aim of the study was to find out the association of FENa with prognosis of decompensated heart failure patients.One hundred and seventy eligible patients with a primary diagnosis of decompensated heart

2015 Journal of clinical and diagnostic research : JCDR

12. Urinary sodium excretion after gastric bypass surgery. (Abstract)

blood samples from each study day were assayed for pro-B-type natriuretic peptide (NT-proBNP).Increases in weight-normalized urinary sodium excretion of up to 2.3-fold in magnitude occurred at 20 months after surgery. Median fractional excretion of sodium at 20 months was double that seen before surgery. Fasting NT-proBNP levels were stable or increased (1.5- to 5-fold). Moreover, a small postprandial increase in NT-proBNP was observed after surgery.Renal fractional excretion of sodium is increased (...) Urinary sodium excretion after gastric bypass surgery. Gut-kidney signaling is implicated in sodium homeostasis and thus blood pressure regulation. Roux-en-Y gastric bypass (RYGB) surgery for morbid obesity confers a pronounced and long-lasting blood pressure lowering effect in addition to significant weight loss.We set out to establish whether RYGB is associated with an intrinsic change in urinary sodium excretion that may contribute to the reported blood pressure lowering effects

2017 Surgery for Obesity and Related Diseases

13. Effect of tolvaptan on renal water and sodium excretion and blood pressure during nitric oxide inhibition: a dose-response study in healthy subjects. Full Text available with Trip Pro

-NMMA (L-NG-monomethyl-arginine).In a randomized, placebo-controlled, double blind, cross over study, 15 healthy subjects received tolvaptan 15, 30 and 45 mg or placebo. L-NMMA was given as a bolus followed by continuous infusion during 60 min. We measured urine output (UO), free water clearance (CH2O), fractional excretion of sodium (FENa), urinary aquaporin-2 channels (u-AQP2) and epithelial sodium channels (u-ENaCγ), plasma vasopressin (p-AVP) and central blood pressure (cBP).During baseline (...) , FENa was unchanged. Tolvaptan decreased u-ENaCγ dose-dependently and increased p-AVP threefold, whereas u-AQP2 was unchanged. During tolvaptan with NO-inhibition, UO and CH2O decreased dose-dependently. FENa decreased dose-independently and u-ENaCγ remained unchanged. Central BP increased equally after all treatments.During baseline, fractional excretion of sodium was unchanged. During tolvaptan with NO-inhibition, renal water excretion was reduced dose dependently, and renal sodium excretion

2017 BMC Nephrology Controlled trial quality: uncertain

14. Sodium zirconium cyclosilicate (Lokelma) - treatment of hyperkalaemia in adult patients

of evidence on comparative efficacy Sodium zirconium cyclosilicate is an orally administered non-polymer inorganic cation exchange crystalline compound. It is not absorbed from the gastro-intestinal tract where it captures potassium cations in exchange for hydrogen and sodium cations, thereby reducing the amount of absorbable free potassium, increasing faecal excretion of potassium and decreasing serum potassium. 1,2 It is licensed for treatment of hyperkalaemia (high serum potassium) in adults 1 (...) Sodium zirconium cyclosilicate (Lokelma) - treatment of hyperkalaemia in adult patients 1 Published 10 February 2020 1 SMC2233 sodium zirconium cyclosilicate 5g and 10g powder for oral suspension (Lokelma®) AstraZeneca UK Ltd 10 January 2020 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in NHSScotland. The advice is summarised as follows: ADVICE: following a full

2020 Scottish Medicines Consortium

15. Renal hyperfiltration is associated with glucose-dependent changes in fractional excretion of sodium in patients with uncomplicated type 1 diabetes. Full Text available with Trip Pro

Renal hyperfiltration is associated with glucose-dependent changes in fractional excretion of sodium in patients with uncomplicated type 1 diabetes. Renal hyperfiltration is a common abnormality associated with diabetic nephropathy in patients with type 1 diabetes (T1D). In animal models, increased proximal tubular sodium reabsorption results in decreased distal sodium delivery, tubuloglomerular feedback activation, afferent vasodilatation, and hyperfiltration. The role of tubular factors (...) is less well understood in humans. The aim of the current study was therefore to compare the fractional sodium excretion (FENa) in hyperfiltering (T1D-H) versus normofiltering (T1D-N) patients and healthy control (HC) subjects, as well as the role of ambient hyperglycemia on FENa.Blood pressure, renal function (inulin for glomerular filtration rate [GFR], and paraaminohippurate for effective renal plasma flow), FENa, and circulating neurohormones were measured in T1D-H (n = 28, GFR ≥135 mL/min/1.73 m

2014 Diabetes Care

16. Sodium zirconium cyclosilicate (Lokelma) - Hyperkalemia

and faecal concentrations of calcium and magnesium. The serum concentrations of all these electrolytes remained unchanged. In the GLP toxicity studies in dogs, oral administration of sodium zirconium cyclosilicate also decreased the urinary fractional excretion of potassium (FE-K) in a dose dependent manner by 85-95% and significantly reduced the serum potassium concentration at the highest doses when administered at 1000 mg/kg/tid for 28 days or at 2000 mg/kg/day for 9 months. These dosages, equivalent (...) the gastrointestinal tract and the equilibrium will occur quite rapidly. In vivo, the administration of ZS-9 decreased the urinary excretion of potassium and urea nitrogen and increased the fecal excretion of potassium and urea nitrogen in a dose dependent manner when administered in the diet to Sprague-Dawley rats at doses up to 6 g/kg/day. These changes were accompanied by corresponding increases in urinary sodium concentration and decreases in faecal sodium excretion. There was no effect on the urinary

2018 European Medicines Agency - EPARs

17. Regulation of hepatic transport of bile salt. Effect of protein synthesis inhibition on excretion of bile salts and their binding to liver surface membrane fractions. Full Text available with Trip Pro

Regulation of hepatic transport of bile salt. Effect of protein synthesis inhibition on excretion of bile salts and their binding to liver surface membrane fractions. The overall transport of bile salts across the hepatocyte is characterized as a carrier-mediated process whose rate-limiting step is biliary secretion. Specific bile salt binding proteins have been identified in liver surface membrane fractions and were postulated to represent the initial interaction in bile salt translocation (...) not demonstrate necrosis or fat accumulation. The latter demonstrated minimal disorganization of rough endoplasmic reticulum and occasional lamellar whorls. 16 h after cycloheximide administration bile salt independent bile flow, basal bile salt excretion, and basal bile flow were unaltered, but the maximum bile salt transport capacity was reduced to 62% of control and 24 h later to 38%. Decreased bile salt transport was reversible, for it returned to control values after 48 h, when hepatic protein synthesis

1979 Journal of Clinical Investigation

18. Urinary output and fractional excretion of sodium and urea as indicators of transient versus intrinsic acute kidney injury during early sepsis Full Text available with Trip Pro

Urinary output and fractional excretion of sodium and urea as indicators of transient versus intrinsic acute kidney injury during early sepsis The pathophysiology of acute kidney injury (AKI) in sepsis is ill defined. We investigated parameters associated with low glomerular filtration, and their predictive value to discriminate transient from intrinsic septic AKI.In 107 sepsis patients, AKI was defined by the Risk, Injury, Failure, Loss of Kidney Function, End-stage renal disease (RIFLE (...) ) urinary output or serum creatinine criterion, or both. Transient AKI (TAKI) versus intrinsic AKI was defined as RIFLE R, I, or F on the first day evolving to no AKI or not, respectively, over the following 5 days. Fractional excretion of sodium (FENa), urea (FEUrea), and NGAL (FENGAL) at admission (d0t0), 4 (d0t4), and 24 hours (d1) was determined.Including versus not including the urinary-output criterion of RIFLE increased AKI from 43% to 64.5%. Median uNGAL levels and FENGAL were lower in no AKI

2013 Critical Care

19. Pentosan polysulfate sodium (Elmiron) - Interstitial Cystitis

information The information on pentosan polysulfate sodium is provided according to the Active Substance Master File (ASMF) procedure. The chemical name of pentosan polysulfate sodium is (1?4)- ß-D–xylan 2,3–bis (hydrogen sulfate) sodium salt corresponding to the molecular formula (C 5 H 6 Na 2 O 10 S 2 ) n and has weight average molecular weight (obtained by light scattering and gel chromatography) of approximately 5760 g/mol and number average molecular weight (the ordinary arithmetic mean or average (...) Pentosan polysulfate sodium (Elmiron) - Interstitial Cystitis 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5520 Send a question via our website www.ema.europa.eu/contact © European Medicines Agency, 2017. Reproduction is authorised provided the source is acknowledged. 23 March 2016 EMA/287422/2017 Committee for Medicinal Products for Human Use (CHMP) Assessment report elmiron

2017 European Medicines Agency - EPARs

20. Nusinersen sodium (Spinraza) - Spinal Muscular Atrophy

Nusinersen sodium (Spinraza) - Spinal Muscular Atrophy 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5520 Send a question via our website www.ema.europa.eu/contact © European Medicines Agency, 2017. Reproduction is authorised provided the source is acknowledged. 21 April 2017 EMA/289068/2017 Committee for Medicinal Products for Human Use (CHMP) Assessment report Spinraza International (...) with the Guideline on the Environmental Risk Assessment of Medicinal Products for Human use (EMEA/CHMP/SWP/4447/00) was performed. A PEC surface water (1.87X10-6 µg/L) based on a DOSEAI of 12 mg/inhabitant/day and a fraction market penetration of 3.12X10-7 (based on SMA prevalence of 0.0019%), resulted very low and did not trigger the action limit calculation. An evaluation of PBT properties is required if the log Kow is greater than 4.5, and a study supporting the partition coefficient data was in the process

2017 European Medicines Agency - EPARs

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