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A SIMPLE AID TO THE DIFFERENTIAL DIAGNOSIS OF OLIGURIA
Author(s) -
BROWN M. A.,
TREW P. A.,
SMART R. C.
Publication year - 1983
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1983.tb02614.x
Subject(s) - azotemia , medicine , oliguria , urea , renal function , acute tubular necrosis , creatinine , fractional excretion of sodium , urology , sodium , uremia , gastroenterology , chemistry , biochemistry , organic chemistry
A study was conducted in oliguric and acutely azotemic patients, measuring: (i) the fractional excretion of sodium (FE Na ) using creatinine clearance as a measure of glomerular filtration rate, and (ii) sodium clearance relative to urea clearance, designated as the sodium/urea clearance ratio (Na:urea CR). It was found that FE Na discriminated between “tubular” and “non‐tubular” disorders in 96% of patients. Further, Na:urea CR was as discriminating as FE Na . Patients with Na:urea CR above 2.5% can be reliably diagnosed as having acute tubular necrosis or acute urinary tract obstruction; those with a value less than 2.5% will have acute glomerulonephritis or pre‐renal azotemia. As urea and sodium measurements are so readily available, this test can now be applied in the assessment of the oliguric or acutely azotemic patient in any hospital practice. (Aust NZ J Med 1983; 13: 608–612.)