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]
Differential diagnosis of causes of oliguria
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)
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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