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May 1984

Low Fractional Excretion of Sodium: Occurrence With Hemoglobinuric- and Myoglobinuric-Induced Acute Renal Failure

Author Affiliations

From the Renal Unit and the Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston. Dr Corwin is now with Rush-Presbyterian-St Luke's Medical Center, Chicago; Dr Schreiber is now with the Cleveland Clinic Foundation.

Arch Intern Med. 1984;144(5):981-982. doi:10.1001/archinte.1984.00350170131022

• Ten patients with myoglobinuric and hemoglobinuric acute renal failure demonstrated low fractional excretion of sodium (FENa) values (< 1%) during the oliguric phase of their course. Acute renal failure secondary to hemoglobinuria developed in five patients, and five demonstrated acute deterioration with myoglobinuria. The mean serum creatinine level increased from 1.1 mg/dL (range, 0.6 to 1.7 mg/dL) to a maximum of 6.9 mg/dL (range, 2 to 13.1 mg/dL). Although three patients required dialysis, all individuals eventually returned or were returning toward their baseline renal function at discharge. The importance of a low FENa in the setting of myoglobinuric and hemoglobinuric renal failure is reviewed. The findings in this report raise the possibility that a common mechanism may underlie the renal injury in both types of pigment toxicity.

(Arch Intern Med 1984;144:981-982)

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