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Fractional Excretion of Sodium

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121. Fractional Urate Excretion in Nonedematous Hyponatremia

years ] We will attempt to categorize the etiology of nonedematous hyponatremia by the following parameters in decreasing order of importance, total and extracellular water determinations, fractional urate excretion, plasma renin and aldosterone levels, urinary sodium concentration and urine osmolality. We will also determine total and extracellular water in a group suspected of having renal salt wasting by virtue of having increased fractional urate excretion and normal serum sodium concentrations (...) : Single Group Assignment Masking: None (Open Label) Primary Purpose: Diagnostic Official Title: Study of Nonedematous Hyponatremia and the Utility of Fractional Urate Excretion in Hyponatremia and Suspected Renal Salt Wasting Without Hyponatremia- Study Start Date : November 2011 Actual Primary Completion Date : December 2014 Actual Study Completion Date : December 2014 Resource links provided by the National Library of Medicine related topics: available for: Arms and Interventions Go to Arm

2011 Clinical Trials

122. Diagnostic performance of fractional excretion of urea in the evaluation of critically ill patients with acute kidney injury: a multicenter cohort study Full Text available with Trip Pro

Diagnostic performance of fractional excretion of urea in the evaluation of critically ill patients with acute kidney injury: a multicenter cohort study Several factors, including diuretic use and sepsis, interfere with the fractional excretion of sodium, which is used to distinguish transient from persistent acute kidney injury (AKI). These factors do not affect the fractional excretion of urea (FeUrea). However, there are conflicting data on the diagnostic accuracy of FeUrea.We conducted

2011 Critical Care

123. Cerebral Salt-Wasting Syndrome (Overview)

, SIADH primarily occurs due to an inappropriate euvolemic rise in ADH secretion. The relationship among serum urate, fractional excretion of urate, and hyponatremia in cerebral salt-wasting syndrome is unclear. Fractional excretion of urate may remain elevated even after correction of hyponatremia in patients with cerebral salt-wasting syndrome. This is distinct from SIADH, in which the fractional excretion of urate returns to the reference range once the hyponatremia is corrected (...) to stroke in tuberculous meningitis. QJM . 2018 Apr 9. . Sherlock M, O'Sullivan E, Agha A, et al. Incidence and pathophysiology of severe hyponatraemia in neurosurgical patients. Postgrad Med J . 2009 Apr. 85(1002):171-5. . Arieff AI, Gabbai R, Goldfine ID. Cerebral Salt-Wasting Syndrome: Diagnosis by Urine Sodium Excretion. Am J Med Sci . 2017 Oct. 354 (4):350-4. . Wu X, Zhou X, Gao L, et al. Diagnosis and Management of Combined Central Diabetes Insipidus and Cerebral Salt Wasting Syndrome After

2014 eMedicine Pediatrics

124. Cerebral Salt-Wasting Syndrome (Diagnosis)

, SIADH primarily occurs due to an inappropriate euvolemic rise in ADH secretion. The relationship among serum urate, fractional excretion of urate, and hyponatremia in cerebral salt-wasting syndrome is unclear. Fractional excretion of urate may remain elevated even after correction of hyponatremia in patients with cerebral salt-wasting syndrome. This is distinct from SIADH, in which the fractional excretion of urate returns to the reference range once the hyponatremia is corrected (...) to stroke in tuberculous meningitis. QJM . 2018 Apr 9. . Sherlock M, O'Sullivan E, Agha A, et al. Incidence and pathophysiology of severe hyponatraemia in neurosurgical patients. Postgrad Med J . 2009 Apr. 85(1002):171-5. . Arieff AI, Gabbai R, Goldfine ID. Cerebral Salt-Wasting Syndrome: Diagnosis by Urine Sodium Excretion. Am J Med Sci . 2017 Oct. 354 (4):350-4. . Wu X, Zhou X, Gao L, et al. Diagnosis and Management of Combined Central Diabetes Insipidus and Cerebral Salt Wasting Syndrome After

2014 eMedicine Pediatrics

125. The Effect of Sodium Nitrite on Renal Function and Blood Pressure in Healthy Humans. A Dose-response Study

: Placebo Continuous 2 hour infusion of sodium chloride, 25 ml/hour Drug: Placebo Continuous 2 hour infusion of sodium chloride, 25 ml/hour Other Name: Sodium chloride Outcome Measures Go to Primary Outcome Measures : Fractional urinary sodium excretion [ Time Frame: One day ] Secondary Outcome Measures : Nitrite clearance [ Time Frame: One day ] Nitrate clearance [ Time Frame: One day ] Glomerular filtration rate [ Time Frame: One day ] Measured by determent renal clearance of 51Cr-EDTA (51-chrome (...) will be evaluated. Hypothesis Sodium nitrite infusion increases urinary sodium excretion and renal filtration rate lowers blood pressure, central as well as peripheral affects vasoactive hormones it is possible to establish a dose that affects the renal function with only minor effect on the blood pressure. Condition or disease Intervention/treatment Phase Healthy Drug: Sodium nitrite, 40 micrograms/kg/hour Drug: Sodium nitrite, 120 micrograms/kg/hour Drug: Sodium nitrite, 240 micrograms/kg/hour Drug: Placebo

2013 Clinical Trials

126. Epithelial Sodium Channel (ENaC) as a Novel Mechanism for Hypertension and Volume Expansion in Type 2 Diabetes

Go to Primary Outcome Measures : Blood Pressure [ Time Frame: one month ] Change in clinic systolic BP. This BP measure will be the average of three serial BP measurements taken one minute apart after 5 minutes of sitting quietly. Secondary Outcome Measures : Hypertension [ Time Frame: one month ] To demonstrate effect size on relevant hypertension outcomes such as volume status and urinary sodium excretion. Also assess the fractional excretion of sodium (FENa) and chloride (FECI). Endpoint (...) Epithelial Sodium Channel (ENaC) as a Novel Mechanism for Hypertension and Volume Expansion in Type 2 Diabetes Epithelial Sodium Channel (ENaC) as a Novel Mechanism for Hypertension and Volume Expansion in Type 2 Diabetes - 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 Studies Save this study Warning You have reached the maximum number of saved

2013 Clinical Trials

127. Effect of volume expansion with hypertonic- and isotonic saline and isotonic glucose on sodium and water transport in the principal cells in the kidney. Full Text available with Trip Pro

of AQP2 (u-AQP2) and the γ-fraction of ENaC (u-ENaCγ). The effects of an acute intravenous volume load with isotonic saline, hypertonic saline and glucose on u-AQP2, u-ENaCγ and underlying mechanisms have never been studied in a randomized, placebo-controlled trial in healthy humans.We studied the effects of 0.9% saline (23 ml/kg), 3% saline (7 ml/kg) and 5% glucose (23 ml/kg) on u-AQP2 and u-ENaCγ, fractional sodium excretion (FENa), free water clearance (CH2O), and plasma concentrations (...) Effect of volume expansion with hypertonic- and isotonic saline and isotonic glucose on sodium and water transport in the principal cells in the kidney. The renal distal nephron plays an important role in the maintenance of sodium balance, extra cellular volume and blood pressure. The degree of water transport, via aquaporin2 water channels (AQP2), and sodium transport, via epithelial sodium channels (ENaC) in renal collecting duct principal cells are reflected by the level of urinary excretion

2013 BMC nephrology Controlled trial quality: uncertain

128. Blood Pressure in Relation to Interactions Between Sodium Dietary Intake and Renal Handling. Full Text available with Trip Pro

, respectively. We calculated fractional excretion of lithium and fractional distal reabsorption rate of sodium, as markers of proximal and distal sodium handling, respectively. The 766 subjects included 379 men and 478 ambulatory hypertensive patients. They were never treated (n=697) or did not take antihypertensive medication for ≥2 weeks (n=69). In adjusted analyses, none of the associations of urinary sodium excretion, fractional excretion of lithium, and fractional distal reabsorption rate of sodium (...) with clinic or ambulatory blood pressure were statistically significant (P≥0.09). However, there was significant (P=0.01) interaction between urinary sodium excretion and fractional excretion of lithium in relation to nighttime diastolic blood pressure. In tertile 3 but not tertiles 1 and 2 of fractional excretion of lithium, nighttime diastolic pressure was positively associated with urinary sodium excretion (P=0.03). However, nighttime diastolic pressure was higher in tertile 1 than tertile 3

2013 Hypertension

129. L-Carnitine prevents the development of ventricular fibrosis and heart failure with preserved ejection fraction in hypertensive heart disease. (Abstract)

was performed using plasma of Dahl salt-sensitive rats fed high-salt diet, a model of hypertensive HFpEF, and showed decreased free-carnitine levels. Reassessment with enzymatic cycling method revealed the decreased plasma and left-ventricular free-carnitine levels in the HFpEF model. Urinary free-carnitine excretion was increased, and the expression of organic cation/carnitine transporter 2, which transports free-carnitine into cells, was down-regulated in the left ventricle (LV) and kidney in the HFpEF (...) L-Carnitine prevents the development of ventricular fibrosis and heart failure with preserved ejection fraction in hypertensive heart disease. Prognosis of heart failure with preserved ejection fraction (HFpEF) remains poor because of unknown pathophysiology and unestablished therapeutic strategy. This study aimed to identify a potential therapeutic intervention for HFpEF through metabolomics-based analysis.Metabolomics with capillary electrophoresis time-of-flight mass spectrometry

2012 Journal of Hypertension

130. The relative contributions of reabsorptive rate and redistributed nephron filtration rate to changes in proximal tubular fractional reabsorption during acute saline infusion and aortic constriction in the rat Full Text available with Trip Pro

was calculated for filtering nephrons. During hydropenia this value averaged 32.9 +/-7.1 nl/min. Saline infusion increased sodium excretion to 5.5% of the filtered load as the absolute rate of proximal tubular reabsorption decreased 38% and fractional reabsorption decreased 45%. Calculated superficial nephron filtration rate increased 21% which on the average was identical with the simultaneously measured increase in whole kidney filtration rate. Similar results were obtained in a separate group of animals (...) The relative contributions of reabsorptive rate and redistributed nephron filtration rate to changes in proximal tubular fractional reabsorption during acute saline infusion and aortic constriction in the rat The absolute rate of reabsorption by superficial rat proximal tubules was measured by the in situ microperfusion technique under conditions of hydropenia, infusion of saline, and infusion of saline plus aortic constriction sufficient to decrease whole kidney filtration rate below

1971 Journal of Clinical Investigation

131. Assessment of LCZ696 and Valsartan in Asian Patients With Salt-sensitive Hypertension

: LCZ696 400mg QD for 4 weeks Drug: Valsartan Valsartan 320mg tablet once daily Drug: LCZ696 LCZ696 400mg tablet once daily Outcome Measures Go to Primary Outcome Measures : Cumulative Sodium Excretion (Natriuresis) at Day 1 [ Time Frame: 0-6 and 0-24 hours on Day 1 ] Urine will be collected in fractions of 6 to 24 hours post-dose. From each fraction, a sample will be drawn for analysis of sodium Day 1 Secondary Outcome Measures : Cumulative Sodium Excretion (Natriuresis) at Day 28 [ Time Frame: 0-6 (...) and 0-24 hours on Day 28 ] Urine will be collected in fractions of 6 to 24 hours post-dose. From each fraction, a sample will be drawn for analysis of sodium Day 28 Urine Volume (Diuresis) Over Time [ Time Frame: Day -1, Day 1 & Day 28 ] Urine will be collected and volume measured in fractions of 0 to 6 hours and 0 to 24 hours Day-1, Day 1 and Day 28 Seated Office Blood Pressure (BP) (Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP)) Over Time [ Time Frame: Day-1, Day 14 and Day 28

2012 Clinical Trials

132. Effect of Hypertonic Sodium Chloride on Urinary Biomarkers in Healthy Subjects and Patients With Chronic Kidney Disease

activity in the kidney and may be measured after an infusion with hypertonic saline in CKD patients and healthy subjects. Condition or disease Intervention/treatment Phase Nephropathy Other: hypertonic saline Not Applicable Detailed Description: The fractional sodium excretion is elevated as high as 10-20% In patients with chronic kidney disease (CKD) Changes in the sodium intake results in a slower expansion and/or reduction in extracellular fluid in CKD patients. Urinary biomarkers reflects (...) First Posted : June 20, 2012 Last Update Posted : March 4, 2014 Sponsor: Regional Hospital Holstebro Information provided by (Responsible Party): Erling Bjerregaard Pedersen, Regional Hospital Holstebro Study Details Study Description Go to Brief Summary: Patients with chronic kidney disease (CKD) have a defect in the tubular reabsorption of sodium, and therefore the ability to excrete a sodium load is diminished compared to healthy subjects. Urinary biomarkers reflects the water- and sodium-channel

2012 Clinical Trials

133. Effect of nitric oxide inhibition on blood pressure and renal sodium handling: a dose-response study in healthy man. (Abstract)

after 20 minutes of infusion. On the contrary, the fractional excretion of sodium was reduced equally in all three L-NMMA doses. This indicates that sodium excretion is highly sensitive to even small changes in renal NO bioavailability in healthy human. (...) Effect of nitric oxide inhibition on blood pressure and renal sodium handling: a dose-response study in healthy man. Nitric oxide (NO) is a ubiquitous vasodilator and an important regulator of renal sodium excretion. To further investigate the role of NO in renal sodium handling, we studied the effects of the NO synthase inhibitor, NG-monomethyl-L-arginine (L-NMMA), in a crossover dose-response study. During NO inhibition mean arterial pressure increased dose-dependently and reached a plateau

2012 Clinical and experimental hypertension (New York, N.Y. : 1993) Controlled trial quality: uncertain

134. Cerebral salt wasting following tuberculous meningoencephalitis in an infant Full Text available with Trip Pro

in patients with intracranial diseases. We report a 6-month-old girl with CSWS associated with tuberculous meningoencephalitis. She was diagnosed as having CSWS on the basis of hypovolemia, polyuria, natriuresis, and the relatively high level of fractional excretion of uric acid. Aggressive replacement of urine salt and water losses using 0.9% or 3% sodium chloride was done. Fludrocortisone was started at 0.1 mg twice daily on the seventh day of admission and was continued for 17 days. (...) Cerebral salt wasting following tuberculous meningoencephalitis in an infant In patients with central nervous system disease, life-threatening hyponatremia can result from either the syndrome of inappropriate secretion of antidiuretic hormone or cerebral salt wasting. Clinical manifestations of the two conditions may be similar, but their pathogeneses and management protocols are different. Cerebral salt wasting syndrome is a disorder in which excessive natriuresis and hyponatremia occurs

2012 Annals of Indian Academy of Neurology

135. NADPH oxidase inhibition reduces tubular sodium transport and improves kidney oxygenation in diabetes Full Text available with Trip Pro

. The aim was to investigate the effects of acute NADPH oxidase inhibition on tubular Na(+) transport and kidney Po(2) in vivo. Glomerular filtration rate (GFR), renal blood flow (RBF), filtration fraction (FF), Na(+) excretion, fractional Li(+) excretion, and intrarenal Po(2) was measured in control and streptozotocin-diabetic rats during baseline and after acute NADPH oxidase inhibition using apocynin. The effects on tubular transporters were investigated using freshly isolated PTC. GFR was increased (...) Na(+) excretion (+112%) and decreased fractional lithium reabsorption (-10%) in diabetics, resulting in improved cortical (+14%) and medullary (+28%) Po(2). Qo(2) was higher in PTC isolated from diabetic rats compared with control. Apocynin, dimethylamiloride, and ouabain reduced Qo(2), but the effects of combining apocynin with either dimethylamiloride or ouabain were not additive. In conclusion, NADPH oxidase inhibition reduces tubular Na(+) transport and improves intrarenal Po(2) in diabetes.

2012 American Journal of Physiology - Regulatory, Integrative and Comparative Physiology

136. Syndrome of inappropriate antidiuresis and cerebral salt wasting syndrome: are they different and does it matter? Full Text available with Trip Pro

. Carefully conducted studies in patients with CNS disease have indicated that CSW may be more common than SIAD. CSW may be differentiated from SIAD based on the persistence of hypouricemia and increased fractional excretion of urate following the correction of hyponatremia. Hyponatremia should be prevented if possible and treated promptly when discovered in patients with CNS disease as even mild hyponatremia could lead to neurological deterioration. Fluid restriction should not be used for the prevention (...) Syndrome of inappropriate antidiuresis and cerebral salt wasting syndrome: are they different and does it matter? The syndrome of inappropriate antidiudresis (SIAD) and cerebral salt wasting (CSW) are similar conditions with the main difference being the absence or presence of volume depletion. The two conditions may be indistinguishable at presentation, as volume status is difficult to assess, which can lead to under-diagnosis of CSW in patients with central nervous system (CNS) disease

2012 Pediatric Nephrology

137. Segmental sodium reabsorption by the renal tubule in prenatally programmed hypertension in the rat. (Abstract)

abundance of sodium:potassium:chloride (Na(+):K(+):2Cl(-)) co-transporter (NKCC2) leads to enhanced sodium uptake by the TAL. Pregnant Wistar rats were fed a control (18%) or LP (9%) diet. Amiloride (AM), bendroflumethiazide (BF), and furosemide (FUR) were administered acutely to male offspring at 4 weeks of age. Fractional excretion of sodium (FE(Na)) was significantly greater in vehicle-infused LP rats (3.0 ± 0.3%) compared with controls (1.7 ± 0.5, P < 0.01). FE(Na) by the LP proximal tubule did (...) Segmental sodium reabsorption by the renal tubule in prenatally programmed hypertension in the rat. Hypertension and renal dysfunction can be programmed in the rat by prenatal exposure to a low-protein (LP) diet. Expression of the renal thick ascending limb (TAL) sodium transporter NKCC2 is up-regulated, which has been predicted to result in greater sodium reabsorption. However, we have shown that LP rats excrete more not less sodium. The aim of this study was to determine whether the increased

2012 Pediatric Nephrology

138. The epidemiology of hypernatraemia in hospitalised children in Lothian: a 10-year study showing differences between dehydration, osmoregulatory dysfunction and salt poisoning. (Abstract)

of hypernatraemia. In 45 children admitted with 64 separate episodes (11 from a case of salt poisoning), the commonest cause was dehydration secondary to either gastroenteritis or systemic infection; 31% had an underlying chronic neurological disorder. A total of 177 further cases developed hypernatraemia after admission. The commonest causes were dehydration secondary to severe systemic infection and postoperative cardiac surgery. Urine sodium:creatinine ratio and fractional excretion of sodium were both much (...) The epidemiology of hypernatraemia in hospitalised children in Lothian: a 10-year study showing differences between dehydration, osmoregulatory dysfunction and salt poisoning. The relative frequencies of the causes of hypernatraemia in children after the neonatal period are unknown. Salt poisoning and osmoregulatory dysfunction are extremely rare and potentially fatal. In this retrospective 10-year study, the incidence, causes and differential biochemistry of hypernatraemia in children

2012 Archives of Disease in Childhood

139. High nutritional risk is associated with worse health-related quality of life in patients with heart failure beyond sodium intake. (Abstract)

HRQoL after controlling for daily sodium intake.A total of 134 consecutive patients with HF [age 63 ± 11 years, 35% female, 45% New York Heart Association (NYHA) class III/IV, ejection fraction (EF) 33 ± 13%] completed the Nutrition Screening Initiative (NSI) to assess nutritional risk and a 24-h urine sodium excretion assessment to estimate daily sodium intake at baseline. The Minnesota Living with HF Questionnaire was used to evaluate HRQoL at baseline and 6 months later. Hierarchical linear (...) High nutritional risk is associated with worse health-related quality of life in patients with heart failure beyond sodium intake. The most desirable outcome in heart failure (HF) management is to improve health-related quality of life (HRQoL) as a patient-centred health outcome. Nutrition is assumed to be important in HF management, whereas there is little evidence that nutritional risk affects HRQoL, except for sodium.We aimed to determine whether nutritional risk is associated with worse

2012 European Journal of Cardiovascular Nursing

140. Proximal tubular angiotensinogen in renal biopsy suggests nondipper BP rhythm accompanied by enhanced tubular sodium reabsorption. Full Text available with Trip Pro

Proximal tubular angiotensinogen in renal biopsy suggests nondipper BP rhythm accompanied by enhanced tubular sodium reabsorption. The renal capacity for sodium excretion is impaired by a reduction in the glomerular ultrafiltration coefficient and by enhancement of the fractional tubular sodium reabsorption (FRNa), leading to a nondipper circadian blood pressure (BP) rhythm. Angiotensin II in the systemic circulation can be easily filtered across the glomerular capillary walls and stimulates (...) directly with the FRNa (r = 0.39, P = 0.01) and the night/day ratio of BP (r = 0.38, P = 0.02), but not creatinine clearance (r = -0.008, P = 0.9). The night/day ratio of BP was determined by both creatinine clearance (r = -0.36, P = 0.03) and FRNa (r = 0.47, P = 0.006).Tubular sodium reabsorption is stimulated by intrarenal angiotensin II, as indicated by PT-AGT, and contributes to the genesis of the nondipper BP rhythm. Further studies are needed to evaluate whether or not treatment to prevent sodium

2012 Journal of Hypertension

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