Oliguria differential diagnosis: Difference between revisions

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{| class="wikitable"
{| class="wikitable"
! rowspan="4" |Classification by etiology
! rowspan="4" style="background:#4479BA; color: #FFFFFF;" |Classification by etiology
! rowspan="4" |Etiology
! rowspan="4" style="background:#4479BA; color: #FFFFFF;" |Etiology
! colspan="10" |Clinical manifestations
! colspan="10" style="background:#4479BA; color: #FFFFFF;" |Clinical manifestations
! colspan="9" |Paraclinical findings
! colspan="9" style="background:#4479BA; color: #FFFFFF;" |Paraclinical findings
! rowspan="4" |Comments
! rowspan="4" style="background:#4479BA; color: #FFFFFF;" |Comments
|-
|-
! colspan="10" rowspan="2" |Symptoms and signs  
! colspan="10" rowspan="2" style="background:#4479BA; color: #FFFFFF;"  |Symptoms and signs  
! colspan="5" |Lab findings
! colspan="5" style="background:#4479BA; color: #FFFFFF;" |Lab findings
! colspan="4" |Imaging
! colspan="4" style="background:#4479BA; color: #FFFFFF;" |Imaging
|-
|-
! rowspan="2" |CBC  
! style="background:#4479BA; color: #FFFFFF;" |CBC  
! rowspan="2" |KFT  
! style="background:#4479BA; color: #FFFFFF;" |KFT  
! rowspan="2" |Electrolytes
! style="background:#4479BA; color: #FFFFFF;" |Electrolytes
! rowspan="2" |Urine analysis
! style="background:#4479BA; color: #FFFFFF;" |Urine analysis
! rowspan="2" |ABG
! style="background:#4479BA; color: #FFFFFF;" |ABG
! rowspan="2" |Ultrasound
! style="background:#4479BA; color: #FFFFFF;" |Ultrasound
! rowspan="2" |X-ray
! style="background:#4479BA; color: #FFFFFF;" |X-ray
! rowspan="2" |CT
! style="background:#4479BA; color: #FFFFFF;" |CT
! rowspan="2" |MRI
! style="background:#4479BA; color: #FFFFFF;" |MRI
|-
|-
!Fatigue/Lethargy
! align="center" style="background:#4479BA; color: #FFFFFF;" Fatigue/Lethargy
!Thirst
! align="center" style="background:#4479BA; color: #FFFFFF;" Thirst
!DIzziness/Confusion
! align="center" style="background:#4479BA; color: #FFFFFF;" Dizziness/Confusion
!Muscle weakness/cramp
! align="center" style="background:#4479BA; color: #FFFFFF;" Muscle weakness/cramp
!Somatic/visceral pain
! align="center" style="background:#4479BA; color: #FFFFFF;" Somatic/visceral pain
!Vomiting  
! align="center" style="background:#4479BA; color: #FFFFFF;" Vomiting  
!Diarrhea  
! align="center" style="background:#4479BA; color: #FFFFFF;" Diarrhea  
!Tachypnea
! align="center" style="background:#4479BA; color: #FFFFFF;" Tachypnea
!Haematuria/Proteinuria
! align="center" style="background:#4479BA; color: #FFFFFF;" Haematuria/Proteinuria
!Edema
! align="center" style="background:#4479BA; color: #FFFFFF;" Edema
|-
|-
! rowspan="25" |Prerenal
! rowspan="25" style="background:#4479BA; color: #FFFFFF;" |Prerenal
|Alcohol poisoning
|Alcohol poisoning
|
|
Line 664: Line 664:
|
|
|-
|-
! rowspan="15" |Intrinsic renal
! rowspan="15" style="background:#4479BA; color: #FFFFFF;" |Intrinsic renal
|Acute interstitial nephritis
|Acute interstitial nephritis
|
|
Line 1,014: Line 1,014:
|
|
|-
|-
! rowspan="6" |Postrenal
! rowspan="6" style="background:#4479BA; color: #FFFFFF;" |Postrenal
|Bladder outlet obstruction
|Bladder outlet obstruction
|
|

Revision as of 19:30, 20 April 2018

Oliguria Microchapters

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Overview

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Differentiating Oliguria from other Diseases

Epidemiology and Demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]


An expert algorithm to assist in the diagnosis of oliguria can be found here

Overview

There are several life-threatening causes of oliguria which need to be evaluated for first, which include; sepsis, urethral stricture, dehydration and shock . The other possible causes of oliguria can be evaluated by carefully assessing the nature of the symptoms, and obtaining a thorough patient history.

Differential Diagnosis

Life Threatening Causes

Life threatening diseases to exclude immediately include:[1][2]

  • Cardiogenic shock
  • Hypovolemic shock
  • Sepsis
  • Malignant hypertension
  • Perinatal asphyxia
  • Haemorrhage
  • Bleeding esophageal varices
  • Dehydration

Common Causes

  • Acute tubular necrosis
  • Renal vein thrombosis
  • Benign prostatic hyperplasia
  • Nephrotic syndrome
  • Glomerulonephritis
  • Interstitial nephritis

Differential Diagnosis of Back Pain

The following table outlines the major differential diagnoses of back pain.

Classification by etiology Etiology Clinical manifestations Paraclinical findings Comments
Symptoms and signs Lab findings Imaging
CBC KFT Electrolytes Urine analysis ABG Ultrasound X-ray CT MRI
align="center" style="background:#4479BA; color: #FFFFFF;" Fatigue/Lethargy align="center" style="background:#4479BA; color: #FFFFFF;" Thirst align="center" style="background:#4479BA; color: #FFFFFF;" Dizziness/Confusion align="center" style="background:#4479BA; color: #FFFFFF;" Muscle weakness/cramp align="center" style="background:#4479BA; color: #FFFFFF;" Somatic/visceral pain align="center" style="background:#4479BA; color: #FFFFFF;" Vomiting align="center" style="background:#4479BA; color: #FFFFFF;" Diarrhea align="center" style="background:#4479BA; color: #FFFFFF;" Tachypnea align="center" style="background:#4479BA; color: #FFFFFF;" Haematuria/Proteinuria align="center" style="background:#4479BA; color: #FFFFFF;" Edema
Prerenal Alcohol poisoning
Aspergillosis
Asphyxia
Cholera
Cirrhosis
Congestive Heart Failure
Dehydration

- Burns

-Cutaneous loss e.g. sweating

- Inadequate water intake

- Salt-wasting nephropathy

Diabetes insipidus
Diabetes mellitus
Diarrhea and/or vomiting
Drugs/Toxins

-ACE

-Aminoglycosides

-Amphotericin B

-Contrast material

-Cyclosporin

-Diuretics

-Digitalis

-Heavy metals

-Indomethacin

-Tacrolimus

-NSAIDs

Esophageal varices bleeding
Heart disease

-Congenital

-Acquired

Hemorrhage
Hemolysis
Hepatorenal syndrome
Ischemic cardiomyopathy
Malignant hypertension
Myocarditis
Peritonitis
Polycythemia
Respiratory distress syndrome
Shock

- Anaphylactic

- Cardiogenic

-Hypotensive

- Septic

- Toxic

Third space losses

- Capillary leak

- Surgery

- Trauma

Toxic megacolon
Intrinsic renal Acute interstitial nephritis
Acute tubular necrosis
Cancer

-Renal cell carcinoma

-Metastatic cancer

Chronic kidney failure
Congenital kidney disease

- Agenesis

- Dysplasia

- Hypoplasia

- Polycystic

End stage renal disease
Endogenous toxins

- Hemoglobin

- Myoglobin

- Uric acid

Glomerulonephritis
Goodpasture syndrome
Hemolytic uremic syndrome
Nephrolithiasis
Nephrotic syndrome
Thrombosis

- Renal vein

- Renal artery

Transplant rejection
Transient dysfunction of the newborn
Postrenal Bladder outlet obstruction
Benign prostatic hyperplasia
Catheter-related
Chronic prostatitis
Obstructive uropathy
Neurogenic bladder

References

  1. ↑ Anderson RJ, Linas SL, Berns AS, Henrich WL, Miller TR, Gabow PA, Schrier RW (May 1977). "Nonoliguric acute renal failure". N. Engl. J. Med. 296 (20): 1134–8. doi:10.1056/NEJM197705192962002. PMID 854045.
  2. ↑ Dixon BS, Anderson RJ (August 1985). "Nonoliguric acute renal failure". Am. J. Kidney Dis. 6 (2): 71–80. PMID 3895901.


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