Oliguria differential diagnosis: Difference between revisions

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{| class="wikitable"
{| class="wikitable"
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" |Classification by etiology
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" |Classification by etiology
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" |Etiology
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" |[[Etiology]]
! colspan="10" style="background:#4479BA; color: #FFFFFF;" |Clinical manifestations
! colspan="10" style="background:#4479BA; color: #FFFFFF;" |Clinical manifestations
! colspan="9" style="background:#4479BA; color: #FFFFFF;" |Paraclinical findings
! colspan="9" style="background:#4479BA; color: #FFFFFF;" |Paraclinical findings
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! colspan="4" style="background:#4479BA; color: #FFFFFF;" |Imaging
! colspan="4" style="background:#4479BA; color: #FFFFFF;" |Imaging
|-
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" |Fatigue/Lethargy
! align="center" style="background:#4479BA; color: #FFFFFF;" |[[Fatigue]]/[[Lethargy]]
! align="center" style="background:#4479BA; color: #FFFFFF;" |Thirst
! align="center" style="background:#4479BA; color: #FFFFFF;" |[[Thirst]]
! align="center" style="background:#4479BA; color: #FFFFFF;" |Dizziness/Confusion
! 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;" |[[Muscle weakness]]/cramp
! align="center" style="background:#4479BA; color: #FFFFFF;" |Somatic/visceral pain
! 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;" |[[Vomiting]]
! align="center" style="background:#4479BA; color: #FFFFFF;" |Diarrhea  
! align="center" style="background:#4479BA; color: #FFFFFF;" |[[Diarrhea]]
! align="center" style="background:#4479BA; color: #FFFFFF;" |Tachypnea
! align="center" style="background:#4479BA; color: #FFFFFF;" |[[Tachypnea]]
! align="center" style="background:#4479BA; color: #FFFFFF;" |Haematuria/Proteinuria
! align="center" style="background:#4479BA; color: #FFFFFF;" |[[Haematuria]]/[[Proteinuria]]
! align="center" style="background:#4479BA; color: #FFFFFF;" |Edema
! align="center" style="background:#4479BA; color: #FFFFFF;" |[[Edema]]
|CBC
|align="center" style="background:#4479BA; color: #FFFFFF;" |[[CBC]]
|KFT
|align="center" style="background:#4479BA; color: #FFFFFF;" |KFT
|Electrolytes
|align="center" style="background:#4479BA; color: #FFFFFF;" |[[Electrolytes]]
|Urine analysis
|align="center" style="background:#4479BA; color: #FFFFFF;" |Urine analysis
|ABG
|align="center" style="background:#4479BA; color: #FFFFFF;" |[[ABG]]
|Ultrasound
|align="center" style="background:#4479BA; color: #FFFFFF;" |[[Ultrasound]]
|X-ray
|align="center" style="background:#4479BA; color: #FFFFFF;" |[[X-ray]]
|CT
|align="center" style="background:#4479BA; color: #FFFFFF;" |[[CT]]
|MRI
|align="center" style="background:#4479BA; color: #FFFFFF;" |[[MRI]]
|-
|-
! rowspan="25" style="background:#4479BA; color: #FFFFFF;" |Prerenal
! rowspan="25" style="background:#4479BA; color: #FFFFFF;" |Prerenal
|Alcohol poisoning
|[[Alcohol poisoning]]
|
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|-
|-
|Aspergillosis
|[[Aspergillosis]]
|
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|-
|-
|Asphyxia
|[[Asphyxia]]
|
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|-
|-
|Cholera
|[[Cholera]]
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|-
|-
|Cirrhosis
|[[Cirrhosis]]
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|-
|-
|Congestive Heart Failure
|[[Congestive heart Failure]]
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|-
|-
|Dehydration
|[[Dehydration]]
- Burns
- Burns


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|-
|-
|Diabetes insipidus
|[[Diabetes insipidus]]
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|-
|-
|Diabetes mellitus
|[[Diabetes mellitus]]
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|-
|Diarrhea and/or vomiting
|[[Diarrhea]] and/or [[vomiting]]
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|-
|-
|Drugs/Toxins
|[[Drugs]]/Toxins
-ACE
-ACEI


-Aminoglycosides
-[[Aminoglycosides]]


-Amphotericin B
-[[Amphotericin B]]


-Contrast material
-Contrast material


-Cyclosporin
-[[Cyclosporin]]


-Diuretics
-[[Diuretics]]


-Digitalis
-[[Digitalis]]


-Heavy metals
-[[Heavy metals]]


-Indomethacin
-[[Indomethacin]]


-Tacrolimus
-[[Tacrolimus]]


-NSAIDs
-[[NSAIDs]]


|
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|-
|-
|Heart disease
|[[Heart disease]]
-Congenital
-Congenital


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|-
|Hemorrhage
|[[Hemorrhage]]
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|Hemolysis
|[[Hemolysis]]
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|-
|Hepatorenal syndrome
|[[Hepatorenal syndrome]]
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|-
|-
|Ischemic cardiomyopathy
|Ischemic [[cardiomyopathy]]
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|-
|Malignant hypertension
|Malignant [[hypertension]]
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|-
|Myocarditis
|[[Myocarditis]]
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|Peritonitis
|[[Peritonitis]]
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|Polycythemia
|[[Polycythemia]]
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|Respiratory distress syndrome
|[[Respiratory distress syndrome]]
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|-
|-
|Shock  
|[[Shock]]


- Anaphylactic
- Anaphylactic
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- Cardiogenic
- Cardiogenic


-Hypotensive
- Hypotensive


- Septic
- Septic
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- Capillary leak
- Capillary leak


- Surgery
- [[Surgery]]


- Trauma
- [[Trauma]]
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|-
|-
|Toxic megacolon
|[[Toxic megacolon]]
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|-
|-
! rowspan="15" style="background:#4479BA; color: #FFFFFF;" |Intrinsic renal
! rowspan="15" style="background:#4479BA; color: #FFFFFF;" |Intrinsic renal
|Acute interstitial nephritis
|[[Acute interstitial nephritis]]
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|Acute tubular necrosis
|[[Acute tubular necrosis]]
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|-
|Cancer
|[[Cancer]]
-Renal cell carcinoma
-[[Renal cell carcinoma]]


-Metastatic cancer
-Metastatic cancer
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|-
|Chronic kidney failure
|[[Chronic kidney failure]]
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|-
|Congenital kidney disease
|[[Congenital kidney disease]]
- Agenesis
- [[Agenesis]]


- Dysplasia
- [[Dysplasia]]


- Hypoplasia
- [[Hypoplasia]]


- Polycystic  
- [[Polycystic]]
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|-
|-
|End stage renal disease
|[[End stage renal disease]]
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|-
|-
|Endogenous toxins  
|Endogenous toxins  
- Hemoglobin
- [[Hemoglobin]]


- Myoglobin
- [[Myoglobin]]


- Uric acid
- [[Uric acid]]
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|-
|-
|Glomerulonephritis
|[[Glomerulonephritis]]
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|-
|Goodpasture syndrome
|[[Goodpasture syndrome]]
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|-
|Hemolytic uremic syndrome
|[[Hemolytic uremic syndrome]]
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|Nephrolithiasis
|[[Nephrolithiasis]]
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|Nephrotic syndrome
|[Nephrotic syndrome]]
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|-
|Thrombosis
|[[Thrombosis]]


- Renal vein
- [[Renal vein]]


- Renal artery
- [[Renal artery]]
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|-
|-
|Transplant rejection
|[[Transplant rejection]]
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|-
|-
! rowspan="6" style="background:#4479BA; color: #FFFFFF;" |Postrenal
! rowspan="6" style="background:#4479BA; color: #FFFFFF;" |Postrenal
|Bladder outlet obstruction
|[[Bladder outlet obstruction]]
|
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|-
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|Benign prostatic hyperplasia
|[[Benign prostatic hyperplasia]]
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|Chronic prostatitis
|[[Chronic prostatitis]]
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|Obstructive uropathy
|[[Obstructive uropathy]]
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|-
|-
|Neurogenic bladder
|[[Neurogenic bladder]]
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Revision as of 19:58, 20 April 2018

Oliguria Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Oliguria from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

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CT

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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
Fatigue/Lethargy Thirst Dizziness/Confusion Muscle weakness/cramp Somatic/visceral pain Vomiting Diarrhea Tachypnea Haematuria/Proteinuria Edema CBC KFT Electrolytes Urine analysis ABG Ultrasound X-ray CT MRI
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

-ACEI

-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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