Oliguria
| Oliguria | |
| ICD-10 | R34 |
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| ICD-9 | 788.5 |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Oliguria and anuria are the decreased or absent production of urine, respectively.
Definition
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]
Pathophysiology
The pathophysiologic mechanisms causing oliguria can be categorized globally in three different 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, tumour compression urinary outflow, expanding hematoma or fluid collection)
Differential diagnosis of causes of oliguria
The decreased production of urine may be a sign of dehydration, renal failure or urinary obstruction/urinary retention.
Postoperative oliguria
Patients usually have 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]
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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