FEUrea

尿素窒素排泄率

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• 1. 急性腎障害（急性腎不全）におけるナトリウム（FENa）、尿素（FEUrea）、およびその他分子の排泄率 fractional excretion of sodium urea and other molecules in acute kidney injury acute renal failure
• 2. 急性腎障害（急性腎不全）における腎前性疾患および急性尿細管壊死の病因および診断 etiology and diagnosis of prerenal disease and acute tubular necrosis in acute kidney injury acute renal failure
• 3. 低ナトリウム血症を有する成人の評価 evaluation of adults with hyponatremia
• 4. 小児における急性腎障害：臨床的特徴、病因、評価、および診断 acute kidney injury in children clinical features etiology evaluation and diagnosis
• 5. 虚血後（虚血性）の急性尿細管壊死の発症および病因 pathogenesis and etiology of postischemic ischemic acute tubular necrosis

English Journal

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

• Vanmassenhove J, Glorieux G, Hoste E, Dhondt A, Vanholder R, Van Biesen W1.
• Critical care (London, England).Crit Care.2013 Oct 13;17(5):R234. [Epub ahead of print]
• INTRODUCTION: 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.METHODS: In 107 sepsis patients, AKI was defined by the Risk,
• PMID 24119730

• Volume management in the critically ill patient with acute kidney injury.

• Labib M1, Khalid R, Khan A, Khan S.
• Critical care research and practice.Crit Care Res Pract.2013;2013:792830. doi: 10.1155/2013/792830. Epub 2013 Feb 7.
• Acute kidney injury (AKI) frequently occurs in the setting of critical illness and its management poses a challenge for the intensivist. Optimal management of volume status is critical in the setting of AKI in the ICU patient. The use of urine sodium, the fractional excretion of sodium (FeNa), and t
• PMID 23476757

• Risk of poor outcomes with novel and traditional biomarkers at clinical AKI diagnosis.

• Hall IE1, Coca SG, Perazella MA, Eko UU, Luciano RL, Peter PR, Han WK, Parikh CR.
• Clinical journal of the American Society of Nephrology : CJASN.Clin J Am Soc Nephrol.2011 Dec;6(12):2740-9. doi: 10.2215/CJN.04960511. Epub 2011 Oct 27.
• BACKGROUND AND OBJECTIVES: Studies have evaluated acute kidney injury (AKI) using biomarkers in various settings, but their prognostic utility within current practice is unclear. Thus, we sought to determine the prognostic utility of newer biomarkers or traditional markers (fractional excretion of s
• PMID 22034509

Japanese Journal

• じん不全の尿素排せつに関する基礎および臨床的研究

• 日本腎臓学会誌 23(10), 1373-1388, 1981
• NAID 130004168665

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「尿素窒素排泄率」

「尿素窒素排泄率」

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英

fractional excretion of urea, FEurea, FEUrea

同

尿中尿素窒素排泄率 urinary fractional excretion of urea

関

尿素窒素 UN、腎前性腎不全、ナトリウム排泄率 fractional excretion of sodium FENa

概念

• 糸球体で濾過された尿素窒素(UN)のうち実際に尿中に排泄される尿素窒素の割合

定義

尿量(ml/hr)をVとすると

• FENa = C_urea / C_Cr x 100 = (U_urea x V ) / S_urea / ( (U_Cr x V ) / S_Cr )

= U_urea / S_urea / ( U_Cr / S_Cr )

特徴

考える技術 第2版 p.529

• 水利尿が良好な場合、50-65%
• 腎前性急性腎不全　＜35%　　　急性尿細管壊死　＞50%　　前者の場合、代償的に再吸収が亢進。再吸収は利尿薬の影響を受けず。