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Concept
Oliguria
Summary
Oliguria or hypouresis is the low output of urine specifically more than 80 ml/day but less than 400ml/day. The decreased output of urine may be a sign of dehydration, kidney failure, hypovolemic shock, hyperosmolar hyperglycemic nonketotic syndrome (HHNS), multiple organ dysfunction syndrome, urinary obstruction/urinary retention, diabetic ketoacidosis (DKA), pre-eclampsia, and urinary tract infections, among other conditions.
Beyond oliguria is anuria, which represents an absence of urine, clinically classified as below 80 or 100 ml/day.
The term oliguria is derived from oligo-meaning "small, little," + -uria, from the Greek word ouron, meaning "urine".
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 or 500 mL per 24h in adults - this equals 17 or 21 mL/hour. For example, in an adult weighing 70 kg 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.
Perform ultrasound examination of the kidney to rule out obstructive processes.
The 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, cardiogenic shock, diarrhea, G6PD deficiency, 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)
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, when defined as less than 1 mL/kg/h, in infants is not attributed to kidney failure.
Official source
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Related courses (1)
BIO-377: Physiology by systems
Le but est de connaitre et comprendre le fonctionnement des systèmes cardiovasculaire, urinaire, respiratoire, digestif, ainsi que du métabolisme de base et sa régulation afin de déveloper une réflect
Related concepts (16)
Urine
Urine is a liquid by-product of metabolism in humans and in many other animals. Urine flows from the kidneys through the ureters to the urinary bladder. Urination results in urine being excreted from the body through the urethra. Cellular metabolism generates many by-products that are rich in nitrogen and must be cleared from the bloodstream, such as urea, uric acid, and creatinine. These by-products are expelled from the body during urination, which is the primary method for excreting water-soluble chemicals from the body.
Multiple organ dysfunction syndrome
Multiple organ dysfunction syndrome (MODS) is altered organ function in an acutely ill patient requiring medical intervention to achieve homeostasis. Although Irwin and Rippe cautioned in 2005 that the use of "multiple organ failure" or "multisystem organ failure" should be avoided, both Harrison's (2015) and Cecil's (2012) medical textbooks still use the terms "multi-organ failure" and "multiple organ failure" in several chapters and do not use "multiple organ dysfunction syndrome" at all.
Hypovolemia
Hypovolemia, also known as volume depletion or volume contraction, is a state of abnormally low extracellular fluid in the body. This may be due to either a loss of both salt and water or a decrease in blood volume. Hypovolemia refers to the loss of extracellular fluid and should not be confused with dehydration. Hypovolemia is caused by a variety of events, but these can be simplified into two categories: those that are associated with kidney function and those that are not.