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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords:
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
Cardiovascular
Accelerated hypertension , Acute systemic inflammation following acute myocardial infarction , Aneurysmal rupture , Aortic valve ring and critical aortic stenosis , Atheroemboli , Bleeding , Bradyarrhythmias , Capillary leak , Cardiogenic shock , Cholesterol embolism , Complete heart block , Congenital heart disease , Dilated cardiomyopathies , Heart failure , Heat stroke , Hypovolemic shock , Malignant hypertension , myocardial depression , myocardial shock , Myocardial stunning , pericardial tamponade, , Preclampsia , Renal artery stenosis , severe constrictive pericarditis , Superior mesenteric artery occlusion , vasculitis
Chemical/Poisoning
Camphor , Carbon-monoxide
Dental
No underlying causes
Dermatologic
Anaphylaxis and anaphylactoid reactions , Erythroderma , Sweating
Drug Side Effect
ACE inhibitors , Amatoxins , Aminoglycosides , Amphotericin B , Analgesic nephropathy , Anthracyclines , Arsenic trioxide , Bacitracin , Bendamustine , Bleomycin , Capecitabine , Capreomycin , Carbon tetrachloride , Carboplatin , Carmustine , Cidofovir , Cisplatin , Cyclophosphamide , Cyclosporine , Cytarabine , Deferasirox , Etoposide , Exenatide , Fluconazole , Fludarabine and cladribine , Gallium nitrate , Gemcitabine , Gyromitrin , Hetastarch , Hydroxyurea , Ifosfamide , Intravenous immune globulin , Irinotecan , Lenalidomide , Lomustine , Malignant hyperpyrexia following anesthesia , Mannitol , Melphalan , Methotrexate , Micafungin , Mithramycin , Nitrosourea compounds , NSAIDs , Orellanine , Oxaliplatin , Para-amino salicylic acid , Pemetrexed , Pentamidine , Pentostatin , Polymyxin B , Rifampicin , Sulphinpyrazone , Sulphonamide crystalluria Cacluli , Synthetic cannabinoids , Tacrolimus , Taxanes , Telavancin , Temozolomide , Tenofovir , Topotecan , Valacyclovir , Vancomycin , Vinca alkaloids
Ear Nose Throat
No underlying causes
Endocrine
Acute pancreatitis , Addisonian crisis , Diabetic nephropathy , Hypercalciuria , Hyperosmolar non-ketotic diabetic coma , hypoaldosteronism , Myxedema coma , SIADH
Environmental
Burns , Heat stroke , Insect bites , Snake bite (Viperidae)
Gastroenterologic
Bowel strangulation , Colorectal cancer , Hemorrhagic pancreatitis , Hepatic vein thrombosis , Hepatorenal syndrome , Intestinal obstruction, , Intususception of intestine , Acute Pancreatitis , Retroperitoneal fibrosis , Third-space sequestration , Upper or Lower gastrointestinal bleeding
Genetic
Prune belly syndrome , Thrombotic thrombocytopenic purpura , Transient renal dysfunction of the newborn
Hematologic
Disseminated intravascular coagulation , Expanding hematoma , Mismatched blood transfusion , Myoglobinuria , Polycythemia , Porphyria , Renal artery thrombosis , Renal vein thrombosis , Thrombotic thrombocytopenic purpura , transfusion reactions
Iatrogenic
Diarrhea , external drainage , Malignant hyperpyrexia following anesthesia , Mismatched blood transfusion , Multiple organ dysfunction syndrome , Radiotherapy , sweating , Systemic inflammatory response syndrome , Vomiting
Infectious Disease
Diphtheria , Dobrava-Belgrade Virus , Endometriosis , Endotoxic shock , Enteritis , Epidemic dropsy , Hantavirus , Human monocytotropic ehrlichiosis , Lassa fever , Leptospirosis , Malignant malaria , Mycobacterium tuberculosis , Neisseria gonorrhoea , Post-streptococcal glomerulonephritis , Schistosoma haematobium , septic shock , Systemic inflammatory response syndrome , Toxic shock syndrome
Musculoskeletal/Orthopedic
Rhabdomyolysis , Cervical spine injury , Spinal cord compression , Crush syndrome , fractures , Massive bleeding , Multiple traumatic injuries
Neurologic
Cervical spine injury , Eclampsia , Intraventricular hemorrhage , Myelomatosis , Neurogenic bladder , neurogenic shock after central nervous system or spinal cord injury , Prolonged convulsions , Spinal cord compression
Nutritional/Metabolic
Adenine phosphoribosyltransferase deficiency , Bulimia , Cholesterol embolism
Obstetric/Gynecologic
Carcinoma of the uterine cervix , Cervical cancer , Endometriosis , Hydrometrocolpos , Hyperemesis gravidarum , Ovarian hyperstimulation syndrome , Perinatal asphyxia , Postpartum bleeding , Preclampsia , Toxemia of pregnancy (type of Toxemia) , Twin twin transfusion
Oncologic
Benign Prostate hyperplasia , Bladder cancer , Leukaemia , Pelvic tumor , Prostate cancer , Tumor lysis syndrome
Ophthalmologic
No underlying causes
Overdose/Toxicity
Crush syndrome , Drug overdose , heavy metal poisoning , Heme pigments , Myoglobinuria , Porphyria , Radiocontrast media , Rhabdomyolysis , Tumor lysis syndrome
Psychiatric
Bulimia
Pulmonary
Alport syndrome , Massive pulmonary embolism, , Respiratory distress syndrome , Respiratory losses , Severe pulmonary hypertension , Tension pneumothorax
Renal/Electrolyte
Acute cortical necrosis , Acute glomerulonephritis , Acute interstitial nephritis , Acute on chronic renal failure , Acute pyelonephritis , Acute renal failure , Acute tubular necrosis , Addisonian crisis , Alport syndrome , Analgesic nephropathy , Bilateral renal vein occlusion , Burns , Chronic renal failure , End stage kidney disease , Glomerulonephritis , Hepatic vein thrombosis , Hepatorenal syndrome , Hydronephrosis , hypoaldosteronism , Interstitial nephritis , Intrinsic glomerular disease , Nephritic syndrome , Nephrocalcinosis , Nephrolithiasis , Nephrotic syndrome , Post-streptococcal glomerulonephritis , Prerenal failure , Renal insufficiency , Renal papillary necrosis , Renal vein thrombosis , salt-wasting nephropathies , Sulphonamide crystalluria Cacluli , Thrombotic thrombocytopenic purpura
Rheumatology/Immunology/Allergy
Anaphylaxis and anaphylactoid reactions , Antiphospholipid Antibody Syndrome , Disseminated intravascular coagulation , Lichen sclerosus et atrophicus , Mismatched blood transfusion , Multiple organ dysfunction syndrome , Systemic lupus erythematosis , Systemic inflammatory response syndrome , transfusion reactions , Transplant rejection , vasculitis
Sexual
Benign Prostate hyperplasia , Hydrometrocolpos
Trauma
Acute blood loss , Cervical spine injury , Crush syndrome , fractures , Massive bleeding , Multiple traumatic injuries , Neurogenic bladder , Neurogenic shock after central nervous system or spinal cord injury , Ruptured hematoma , Shock , Upper or Lower gastrointestinal bleeding
Urologic
Benign Prostate hyperplasia , Bladder cancer , Bladder outlet obstruction , Hydronephrosis , Kidney stone , Nephrotic syndrome , Obstruction of the urinary tract , Pelvic tumor , Prostate cancer , Schistosoma haematobium , Sulphonamide crystalluria Cacluli , Ureterocele , Urethral catheterization , Urethral stricture , Urethral trauma
Miscellaneous
Puerperal shock , Radiotherapy , Surgery complication
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:
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]
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
Has there been fever?
Has there been diarrhea ?
Has there been vomiting ? With or without nausea ?
Is thirst decreased?
What other symptoms does the patient have?
Other
What medications does the patient take?
Does the patient have any allergies ?
Does the patient have access to adequate fluids?
Medical history
Has the patient had any recent injuries such as burns ?
Has the patient been sick?
Does the patient have a history of a problem with the kidneys or bladder ? Laboratory Findings 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.
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