Oliguria: Difference between revisions
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**Has it rapidly become worse? | **Has it rapidly become worse? | ||
* Quality | * Quality | ||
**How much | **How much does the patient drink each day? | ||
**Does drinking more increase | **Does drinking more increase the daily urine output? | ||
**How much urine | **How much urine does the patient produce each day? | ||
**What color is the [[urine]]? | **What color is the [[urine]]? | ||
* Aggravating factors | * Aggravating factors | ||
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**Has there been [[vomiting]]? With or without [[nausea]]? | **Has there been [[vomiting]]? With or without [[nausea]]? | ||
**Is thirst decreased? | **Is thirst decreased? | ||
**What other symptoms | **What other symptoms does the patient have? | ||
* Other | * Other | ||
**What medications | **What medications does the patient take? | ||
** | **Does the patient have any [[allergies]]? | ||
** | **Does the patient have access to adequate fluids? | ||
* Medical history | * 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 [[kidney]]s or [[bladder]]? | ||
===Laboratory Findings=== | ===Laboratory Findings=== | ||
* Blood studies to monitor [[electrolyte]]s and kidney function. | * Blood studies to monitor [[electrolyte]]s and kidney function. | ||
Revision as of 14:17, 8 March 2013
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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
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
- 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.