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Old 10-24-2014
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Post Acute kidney inury -- help!

Hi guys!
I need help with 2 points here in Acute kidney injury. FA14 pg 544.

1. Check if my thought is right please.
It should be considered that normal FENa is 0.95%...
Then:

Prerenal: FENa is <1% and Urine osmolality >500.
So a urine with less sodium also have less water and the urine osmolality should be high or higher than 500.

Intrinsic: FENa >2% and Urine osmolality <350.
Urine with more sodium have more water and the urine osmolality should be low or lower than 350.

Postrenal: FENa > 1 or 2% and Urine osmolality <350.
Same as intrinsic, Urine with more sodium have more water and the urine osmolality should be low or lower than 350.

2. In intrinsic azotemia both bun urea and creatinine are lost proportionally in the urine but you can't reabsorb urea because the proximal tubule cells are damaged and the rate of Bun:Cr will keep equal or less of 15:1.
It can be less than 15:1 because of extrarenal loss of urea (skin/bowel)

Thanks guys.
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