Fractional Excretion of Urea: A Simple Tool for the Differential Diagnosis of Acute Kidney Injury in ICU Patients

Document Type : Original Article

Authors

1 Department of Internal Medicine, Faculty of Medicine, Aswan University

2 Department of Biochemistry and Molecular biology , Faculty of Medicine, Aswan University

3 Department of Clinical Pathology, Faculty of Medicine, Aswan University

Abstract

Background and Aim: Fractional excretion of filtered sodium (FENa) is a tool utilized to determine the origin of acute renal damage. Our goal was to determine, within certain limitations, how useful fractional excretion of urea (FEUrea) is as a clinical tool for distinguishing between acute tubular necrosis (ATN) and prerenal azotemia (PRA) in intensive care unit (ICU) patients with AKI.
Methodology: This cross-sectional trial was done amongst May 2023 and January 2024 and one hundred and six participants were involved in the analysis. All participants' demographic and laboratory data are used to determine the cause of AKI as well as the clinical evaluation. Using these data, FEUrea and FENa were calculated.
Results: The mean age in the PRA group was 48.91 ± 11.41 while in the ATN group 49.55 ± 10.38. We detected that FEUrea and FENa were significantly increased in the ATN group than PRA group (P value 0.044 and <0.001 respectively). FEUrea and FENa can significantly predict ATN (P value 0.041 and P value under 0.001 respectively) at different cut-off values.
Conclusion: Our findings highlight the clinical value of FEUrea and FENa as indicators in the early discrimination of ATN from PRA in ICU patients with Acute kidney injury, facilitating timely and targeted interventions based on the underlying etiology.
KEYWORDS: Acute kidney injury, FEUrea, FENa.

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