TEN Nefrologia Practice Questions - TEN - Título De Especialista Em Nefrologia (Sociedade Brasileira De Nefrologia AMB) Exam

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A 70-year-old man with acute decompensated heart failure is receiving intravenous furosemide 80 mg twice daily. Over 72 hours, his serum creatinine increases from 1.2 mg/dL to 2.8 mg/dL, and his urine sodium is 48 mEq/L. You suspect prerenal azotemia from intravascular volume contraction, but recognize that loop diuretics invalidate the FENa calculation. Serum BUN is 70 mg/dL, serum creatinine is 2.8 mg/dL, urine urea nitrogen is 350 mg/dL, and urine creatinine is 100 mg/dL. What is the calculated Fractional Excretion of Urea (FEUrea), and how is it interpreted?

FEUrea = 48.2%, indicating acute tubular necrosis (ATN) FEUrea = 62.5%, indicating intrinsic drug nephrotoxicity FEUrea = 28.0%, indicating prerenal azotemia despite loop diuretic therapy FEUrea = 12.5%, indicating postrenal obstructive uropathy

Correct Answer:

FEUrea = 28.0%, indicating prerenal azotemia despite loop diuretic therapy

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