Urinary indices for differentiation of prerenal azotemia and renal azotemia in horses.

The urine urea nitrogen/plasma urea nitrogen ratio (Uun/Pun), urine creatinine/plasma creatinine ratio (Ucr/Pcr), urine osmolality/plasma osmolality ratio (Uosm/Posm), and fractional excretion of filtered sodium (FENa) were evaluated in 16 horses with acute azotemia to ascertain the significance of each index in the differentiation of prerenal azotemia from renal azotemia. Renal azotemia was diagnosed when renal biopsy or postmortem histologic examination demonstrated evidence of organic renal disease or when azotemia was found in the presence of isosthenuria. The diagnosis of prerenal azotemia was based on the absence of renal histologic lesions or stabilization of blood urea nitrogen and serum creatinine soon after therapy. In 10 horses with renal azotemia, Uun/Pun was 2.1-14.3, Ucr/Pcr was 2.6-37.0, Uosm/Posm was 0.8-1.7, and FENa was 0.08-10.0. In 6 horses with prerenal azotemia, Uun/Pun was 15.2-43.7, Ucr/Pcr was 51.2-241.5, Uosm/Posm was 1.7-3.4, and FENa was 0.02-0.50. The values for each of these indices differed significantly between the 2 groups of horses (P less than 0.05). It was concluded that these indices were of value in the early classification of renal failure in the horse and that this information could be utilized in planning of therapy of acute azotemia in the horse.