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Fractional Excretion of Sodium

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1. Interpretation of the Fractional Excretion of Sodium in the Absence of Acute Kidney Injury: A Cross-Sectional Study (PubMed)

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

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2017 Nephron. Clinical practice

2. 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

3. Effect of Fenoldopam Continuous Infusion on Glomerular Filtration Rate and Fractional Excretion of Sodium in Healthy Dogs (PubMed)

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

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2016 Journal of Veterinary Internal Medicine

4. 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

5. Low sodium status in cystic fibrosis-as assessed by calculating fractional Na<sup>+</sup> excretion-is associated with decreased growth parameters. (PubMed)

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

6. Fractional excretion of sodium in hepatorenal syndrome: Clinical and pathological correlation (PubMed)

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

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2016 World journal of hepatology

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

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 Short-Term Effects of Roux-en-Y Gastric Bypass on Renal Excretion of Sodium and Its Association with Blood Pressure. Bariatric surgery has been shown to be effective in reducing weight and has benefits, such as lowering blood pressure. An increase in urinary sodium excretion has been suggested as a possible mechanism. This study explored changes in sodium excretion and their correlation with blood pressure after Roux-en-Y gastric bypass.This study was conducted on 28 obese participants

2019 Obesity Surgery

8. Effect of sodium nitrite on renal function, sodium and water excretion and brachial and central blood pressure in healthy subjects. A dose-response study. (PubMed)

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

9. Fractional excretion of electrolytes in volume‐responsive and intrinsic acute kidney injury in dogs: Diagnostic and prognostic implications (PubMed)

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.

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2018 Journal of Veterinary Internal Medicine

10. 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

11. Urinary sodium excretion after gastric bypass surgery. (PubMed)

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

12. Effect of tolvaptan on renal water and sodium excretion and blood pressure during nitric oxide inhibition: a dose-response study in healthy subjects. (PubMed)

-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

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2017 BMC Nephrology

13. Fractional Excretion of Sodium and Its Association with Prognosis of Decompensated Heart Failure Patients (PubMed)

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

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2015 Journal of clinical and diagnostic research : JCDR

14. Renal hyperfiltration is associated with glucose-dependent changes in fractional excretion of sodium in patients with uncomplicated type 1 diabetes. (PubMed)

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

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2014 Diabetes Care

15. Utility of fractional excretion of urea in the differential diagnosis of acute kidney injury in children. (PubMed)

Utility of fractional excretion of urea in the differential diagnosis of acute kidney injury in children. The fractional excretion of sodium (FENa) has been used as an index for the differential diagnosis of acute tubular necrosis (ATN) and prerenal acute kidney injury (AKI). The reliability of this index, however, decreases with the use of the diuretic agent furosemide. The fractional excretion of urea nitrogen (FEUN) has been shown to be useful in such settings in adults. The objective

2016 Pediatric Nephrology

16. The Synergistic Roles of Cholecystokinin B and Dopamine D5 Receptors on the Regulation of Renal Sodium Excretion (PubMed)

The Synergistic Roles of Cholecystokinin B and Dopamine D5 Receptors on the Regulation of Renal Sodium Excretion Renal dopamine D1-like receptors (D1R and D5R) and the gastrin receptor (CCKBR) are involved in the maintenance of sodium homeostasis. The D1R has been found to interact synergistically with CCKBR in renal proximal tubule (RPT) cells to promote natriuresis and diuresis. D5R, which has a higher affinity for dopamine than D1R, has some constitutive activity. Hence, we sought (...) to investigate the interaction between D5R and CCKBR in the regulation of renal sodium excretion. In present study, we found D5R and CCKBR increase each other's expression in a concentration- and time-dependent manner in the HK-2 cell, the specificity of which was verified in HEK293 cells heterologously expressing both human D5R and CCKBR and in RPT cells from a male normotensive human. The specificity of D5R in the D5R and CCKBR interaction was verified further using a selective D5R antagonist, LE-PM436

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2016 PloS one

17. 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

18. Urinary output and fractional excretion of sodium and urea as indicators of transient versus intrinsic acute kidney injury during early sepsis (PubMed)

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

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2013 Critical Care

19. Effects of Dietary Sodium and Potassium Intake on Chronic Disease Outcomes and Risks

is unclear regarding the effect of reducing sodium intake on the incidence of hypertension (because of the small number of trials). Prospective cohort studies suggest an association between lower urinary sodium excretion and reduced risk for hypertension (low SoE because of high RoB and lack of consistency). viii Only a small number of RCTs assessed the effects of sodium reduction on longer term chronic disease outcomes: Sodium reduction decreased the risk for the combined outcome of CVD mortality (...) cardiovascular disease event in sodium reduction trials (as reported by the study authors) 66 Figure 23. Relative risk for combined CVD morbidity and mortality 66 Figure 24. Categorical analysis of the association between urinary sodium levels and total mortality outcome in generally healthy populations (data from studies rated low or moderate RoB). 71 Panel a. 24-hour urinary excretion measures 71 Panel b. Dietary sodium intake measures 71 Figure 25. Random-effects model meta-analysis of adjusted relative

2018 Effective Health Care Program (AHRQ)

20. Sodium and Potassium Intake: Effects on Chronic Disease Outcomes and Risks

is unclear regarding the effect of reducing sodium intake on the incidence of hypertension (because of the small number of trials). Prospective cohort studies suggest an association between lower urinary sodium excretion and reduced risk for hypertension (low SoE because of high RoB and lack of consistency). viii Only a small number of RCTs assessed the effects of sodium reduction on longer term chronic disease outcomes: Sodium reduction decreased the risk for the combined outcome of CVD mortality (...) cardiovascular disease event in sodium reduction trials (as reported by the study authors) 66 Figure 23. Relative risk for combined CVD morbidity and mortality 66 Figure 24. Categorical analysis of the association between urinary sodium levels and total mortality outcome in generally healthy populations (data from studies rated low or moderate RoB). 71 Panel a. 24-hour urinary excretion measures 71 Panel b. Dietary sodium intake measures 71 Figure 25. Random-effects model meta-analysis of adjusted relative

2018 Effective Health Care Program (AHRQ)

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