Oliguria

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(′äl·ə′gyu̇r·ē·ə)

(medicine) Diminished excretion of urine.


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IN BRIEF: n. - Production of an abnormally small amount of urine.

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Reduced daily output of urine. This has veterinary significance if the net intake is normal or if water is available ad lib; then it is a sign of renal insufficiency.

(ol′igyōō′rē ə)
n

A decreased output of urine (usually less than 500 ml/day), possibly associated with dehydration from diarrhea or excessive sweating, low fluid intake, lower nephron nephrosis resulting from burns, heavy metal poisoning, terminal renal disease, or an increase in extracellular fluid volume in untreated renal, cardiac, or hepatic disease.

Oliguria
ICD-10 R34
ICD-9 788.5
MeSH D009846

Oliguria is the low output of urine,[1] It is clinically classified as an output below 300-500ml/day[2]. The decreased output of urine may be a sign of dehydration, renal failure, hypovolemic shock, HHNS Hyperosmolar Hyperglycemic Nonketotic Syndrome, multiple organ dysfunction syndrome, urinary obstruction/urinary retention, Pre-eclampsia, and Urinary tract infections.

It can be contrasted with anuria, which represents an absence of urine, clinically classified as below 50ml/day[3].

Contents

Definition

Oliguria is defined as a urine output that is less than 1 mL/kg/h in infants,[4] less than 0.5 mL/kg/h in children,[4] and less than 400 mL[4] or 500 mL[5] per 24h in adults - this equals 17 or 21 mL/hour. For example, in an adult weighing 70kg it equals 0.24 or 0.3 ml/hour/kg. Alternatively, however, the value of 0.5 mL/kg/h is commonly used to define oliguria in adults as well.[5]

Olig- (or oligo-) is a Greek prefix meaning small or few.[6]

Anuria is defined as less than 50mL urine output per day.

Testing

Perform ultrasound examination of the kidney to rule out obstructive processes.

Pathophysiology

The pathophysiologic mechanisms causing oliguria can be categorized globally in three different categories[7]:

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.[8]

References

  1. ^ "oliguria" at Dorland's Medical Dictionary
  2. ^ Boon et al, Davidson's Principles & Practice of Medicine (20th Ed), p475
  3. ^ Boon et al, Davidson's Principles & Practice of Medicine (20th Ed), p475
  4. ^ a b c Klahr S, Miller S (1998). "Acute oliguria". N Engl J Med 338 (10): 671–5. doi:10.1056/NEJM199803053381007. PMID 9486997.  Free Full Text.
  5. ^ a b Merck manuals > Oliguria Last full review/revision March 2009 by Soumitra R. Eachempati
  6. ^ http://biology.about.com/od/prefixesandsuffixeso/g/blo3.htm
  7. ^ http://beavermedic.wordpress.com/2010/01/19/the-kidneys/
  8. ^ Arant B (1987). "Postnatal development of renal function during the first year of life". Pediatr Nephrol 1 (3): 308–13. doi:10.1007/BF00849229. PMID 3153294. 

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