Corwin H L, Schreiber M J, Fang L S
Arch Intern Med. 1984 May;144(5):981-2. doi: 10.1001/archinte.144.5.981.
Ten patients with myoglobinuric and hemoglobinuric acute renal failure demonstrated low fractional excretion of sodium (FENa) values (less than 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.
10例肌红蛋白尿性和血红蛋白尿性急性肾衰竭患者在病程的少尿期表现出低钠排泄分数（FENa）值（低于1%）。5例患者继发于血红蛋白尿的急性肾衰竭，5例表现为肌红蛋白尿导致的急性肾功能恶化。血清肌酐平均水平从1.1mg/dL（范围0.6至1.7mg/dL）升至最高6.9mg/dL（范围2至13.1mg/dL）。尽管3例患者需要透析，但所有患者最终在出院时均恢复或正在恢复至基线肾功能。本文回顾了低FENa在肌红蛋白尿性和血红蛋白尿性肾衰竭中的重要性。本报告中的研究结果提示，两种类型的色素毒性导致肾损伤可能存在共同机制。
