Fractional excretion tests: a critical review of methods and applications in domestic animals

The fractional excretion (FE) of a constituent by the kidney is the fraction of the amount filtered by the glomerulus, which is excreted into urine. It is mostly determined for electrolytes, and is expressed as the ratio of the clearance of a given electrolyte to creatinine clearance. The main physiologic factors affecting FE variation are species, age, and the alimentary supply of electrolytes. The value of FE tests in the diagnosis of kidney disease is limited, except in canine Fanconi's syndrome. FEs of many constituents often are increased in chronic kidney disease, but their diagnostic value is no greater than that of plasma creatinine concentration. FEs also are altered in nonrenal diseases such as diabetes mellitus and rhabdomyolysis, and during treatment with xylazine, rehydration fluids, and diuretics. FEs, especially of calcium, phosphates, and magnesium, are useful in clinical nutrition to assess mineral balance. FE is difficult to measure, so its use should be limited to nutritional investigations and nephrology research.