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Nephrology

Fractional Excretion of Sodium (FENa)

4 inputsNephrology

Differentiates pre-renal AKI from intrinsic.

Fractional Excretion of Sodium (FENa) calculator

Result

0.3%

< 1% — Pre-renal (avid Na reabsorption)

Unreliable if diuretics given. Use FEUrea if on diuretics.

Lab units

Switching converts the values you entered.

1 to 200 mmol/L

100 to 170 mmol/L

1 to 500 mg/dL

0.3 to 20 mg/dL

How to use it

  1. 1

    Spot urine and serum at same time. Collect both samples simultaneously for accuracy.

  2. 2

    FENa formula. FENa% = (UNa × PCr) / (PNa × UCr) × 100.

  3. 3

    Diuretics confound FENa. Furosemide ↑ urine Na → falsely high FENa. Use FEUrea instead.

When to use it

AKI work-up without diuretics
Classic use: oliguria, ↑ creatinine — is this pre-renal or ATN?
Not useful in CKD
CKD patients often spill more Na; FENa less discriminating.
Heart failure and hepatorenal
FENa < 1% in HRS despite ATN-like picture — use clinical context.

A reference for clinicians and students, not medical advice. A score supports a decision; it does not make one. Check every result against the patient in front of you and your local protocol.

At a glance

Specialty
Nephrology
Inputs
4
Type
Formula

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