Oliguria pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

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Pathophysiology

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.