Oliguria: Difference between revisions
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*[[Antiphospholipid Antibody Syndrome]] | *[[Antiphospholipid Antibody Syndrome]] | ||
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*[[ | *[[Hemorrhagic pancreatitis]] | ||
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*[[ | *[[Hypoaldosteronism]] | ||
*[[Hypovolemic shock]] | *[[Hypovolemic shock]] | ||
*[[Ifosfamide]] | *[[Ifosfamide]] | ||
*[[Impaired renal function]] | *[[Impaired renal function]] | ||
*[[ | *[[Insect bites]] | ||
*[[Interstitial nephritis]] | *[[Interstitial nephritis]] | ||
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*[[Rhabdomyolysis]] | *[[Rhabdomyolysis]] | ||
*[[Rifampicin]] | *[[Rifampicin]] | ||
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*[[ | *[[Salt-wasting nephropathies ]] | ||
*[[Schistosoma haematobium]] | *[[Schistosoma haematobium]] | ||
*[[ | *[[Septic shock ]] | ||
*[[ | *[[Severe constrictive pericarditis ]] | ||
*[[Severe hypoperfusion]] | *[[Severe hypoperfusion]] | ||
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*[[Systemic inflammatory response syndrome ]] | *[[Systemic inflammatory response syndrome ]] | ||
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*[[Temozolomide]] | *[[Temozolomide]] | ||
*[[Tenofovir]] | *[[Tenofovir]] | ||
*[[ | *[[Tension pneumothorax]] | ||
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For patient information page click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Decreased urine output; reduced urine output
Overview
Oliguria and anuria are the decreased or absent production of urine, respectively.
Oliguria is defined as a urine output that is less than 1 mL/kg/h in infants, less than 0.5 mL/kg/h in children, and less than 400 mL/day (equals 17mL/hour) in adults.[1]
Causes
Common Causes
- List the most common causes here.
Causes by Organ System
Causes in Alphabetical Order
The mechanisms causing oliguria can be divided into several categories:
Prerenal
In response to hypoperfusion of the kidney (e.g. as a result of dehydration by poor oral intake, diarrhea, massive bleeding or sepsis)
Renal
Due to kidney damage (severe hypoperfusion, rhabdomyolysis, medication)
Postrenal
As a consequence of obstruction of the urine flow (e.g. enlarged prostate, tumor compression urinary outflow, expanding hematoma or fluid collection)
The decreased production of urine may be a sign of dehydration, renal failure or urinary obstruction/urinary retention.
Postoperative Oliguria
Patients usually have a decrease in urine output after a major operation that may be a normal physiological response to:
- Fluid/blood loss – decreased glomerular filtration rate secondary to hypovolemia and/or hypotension
- Response of adrenal cortex to stress -increase in aldosterone (Na and water retention) and antidiuretic hormone (ADH) release
Oliguria in Infants
Oliguria, when defined as less than 1 mL/kg/h, in infants is not considered to be a reliable sign of renal failure.[2]==Risk Factors== Patients having any of the conditions mentioned in the causes are at risk of oliguria.
Natural History, Complications and Prognosis
Although a significant decrease in urine output may indicate a serious, even life-threatening condition, adequate urine output can be restored with prompt medical treatment.
Diagnosis
History and Symptoms
History of
- Time pattern
- When did this begin?
- Did it occur suddenly?
- Has it rapidly become worse?
- Quality
- How much does the patient drink each day?
- Does drinking more increase the daily urine output?
- How much urine does the patient produce each day?
- What color is the urine?
- Aggravating factors
- Other
- What medications does the patient take?
- Does the patient have any allergies?
- Does the patient have access to adequate fluids?
- Medical history
Laboratory Findings
- Blood studies to monitor electrolytes and kidney function.
- Urine tests, including tests for infection.
Treatment
Medical Therapy
It mainly depends on the cause:
Home Care
The patient should follow prescribed fluid regimens and measure urine output as directed.
Primary Prevention
Prevention depends on the underlying cause.
References
- ↑ Klahr S, Miller S (1998). "Acute oliguria". N Engl J Med. 338 (10): 671–5. PMID 9486997. Free Full Text.
- ↑ Arant B (1987). "Postnatal development of renal function during the first year of life". Pediatr Nephrol. 1 (3): 308–13. PMID 3153294.