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Fractional excretion of sodium

Alternative Names: FE sodium; FENa

Fractional excretion of sodium (FENa) is the amount of salt (sodium) that leaves your body through urine compared to the amount filtered and reabsorbed by the kidney.

FENa is not a test, but rather a calculation based on the concentrations of sodium and creatinine in your blood and urine. Urine and blood chemistry tests are necessary to perform this calculation.

Why is the Test Performed?

The test is usually done for patients who are severely ill with acute kidney insufficiency. The test helps determine if the drop in urine production is due to reduced blood flow to the kidney or to kidney damage itself.

How is the Test Performed?

Blood and urine samples are sent to a lab, where they are examined for their salt (sodium) and creatinine levels.

For information on how a blood sample is taken from a vein, see venipuncture.

For information on giving a urine sample, see clean catch urine sample.

Preparation for the Test

Eat a normal diet with a normal amount of salt, unless otherwise instructed by your doctor.

Your health care provider will instruct you, if necessary, to discontinue drugs that may interfere with test results. Certain diuretic medicines may affect test results.

How will the Test Feel?

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Fractional excretion of sodium Risks

The urine sample has no risk. The risks of drawing blood include:

  • Excessive bleeding
  • Fainting or feeling lightheaded
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)
  • Multiple punctures to locate veins

Considerations

The test is only of value in specific circumstances such as sudden reduced urine output.

What Abnormal Results Mean

A meaningful interpretation of the test can be made only when your urine volume has dropped to less than 500 mL/day.

A FENa of less than 1% indicates decreased blood flow to the kidney, while a FENa greater than 1% (and usually greater than 3%) suggests kidney damage.

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Review Date: 11/30/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Herbert Y. Lin, MD, PHD, Nephrologist, Massachusetts General Hospital; Associate Professor of Medicine, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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