Oliguria: Difference between revisions
| Line 73: | Line 73: | ||
===Medical Therapy=== | ===Medical Therapy=== | ||
It mainly depends on the cause: | It mainly depends on the cause: | ||
===Home Care=== | ====Home Care==== | ||
The patient should follow prescribed fluid regimens and measure urine output as directed. | The patient should follow prescribed fluid regimens and measure urine output as directed. | ||
Revision as of 14:25, 8 March 2013
|
WikiDoc Resources for Oliguria |
|
Articles |
|---|
|
Most recent articles on Oliguria |
|
Media |
|
Evidence Based Medicine |
|
Clinical Trials |
|
Ongoing Trials on Oliguria at Clinical Trials.gov Clinical Trials on Oliguria at Google
|
|
Guidelines / Policies / Govt |
|
US National Guidelines Clearinghouse on Oliguria
|
|
Books |
|
News |
|
Commentary |
|
Definitions |
|
Patient Resources / Community |
|
Directions to Hospitals Treating Oliguria Risk calculators and risk factors for Oliguria
|
|
Healthcare Provider Resources |
|
Causes & Risk Factors for Oliguria |
|
Continuing Medical Education (CME) |
|
International |
|
|
|
Business |
|
Experimental / Informatics |
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
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.