Calculators & Tools

FeNa Calculator

Fractional excretion of sodium in acute kidney injury

1 What is the FeNa Calculator?

Calculates the fractional excretion of sodium, the proportion of filtered sodium that appears in the urine. It helps separate a prerenal picture, where sodium is avidly reabsorbed, from intrinsic tubular injury, where it is not.

2 When to use it

  • Distinguishing prerenal azotaemia from acute tubular necrosis
  • Assessing oliguria of unclear cause
  • Interpreting acute kidney injury before deciding on fluid challenge

3 Formula & method

FeNa is calculated from paired urine and serum sodium and creatinine. A low value indicates avid tubular sodium reabsorption, consistent with a prerenal state; a higher value suggests tubular injury. The result is unreliable after diuretics, which force sodium excretion regardless of volume status — in that situation the fractional excretion of urea is more informative.
  • Espinel CH. The FeNa test: use in the differential diagnosis of acute renal failure. JAMA. 1976

4 Frequently asked questions

Does FeNa work if the patient has had furosemide?

No. Diuretics increase sodium excretion independent of volume status and invalidate the test. Fractional excretion of urea is preferred in that setting.

What values suggest prerenal disease?

A low fractional excretion indicates preserved tubular sodium handling and points towards a prerenal cause; the app states the interpretation band for the value entered.

Is FeNa reliable in neonates?

It is harder to interpret. Preterm infants have immature tubular sodium handling and physiologically higher fractional sodium excretion.

What else raises FeNa apart from tubular injury?

Chronic kidney disease, obstruction and salt-wasting states can all raise it, so it should be read alongside the clinical picture.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.