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Oliguria or hypouresis is the low output of
urine Urine is a liquid by-product A by-product or byproduct is a secondary product derived from a production process, process or ; it is not the primary product or service being produced. A by-product can be useful and marketable or it can be cons ...

urine
specifically more than 80 ml/day but less than 400ml/day.Boon et al, Davidson's Principles & Practice of Medicine (20th Ed), p475 The decreased output of urine may be a sign of
dehydration In physiology, dehydration is a lack of total body water In physiology Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology Biology is the natural science that studies ...

dehydration
,
kidney failure Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys are functioning at less than 15% of normal levels. Kidney failure is classified as either acute kidney failure, which develops rapidly and may res ...
,
hypovolemic shock Hypovolemic shock is a medical emergency and an advanced form of hypovolemia due to insufficient amounts of blood and/or fluid In physics, a fluid is a substance that continually Deformation (mechanics), deforms (flows) under an applied shea ...
, hyperosmolar hyperglycemic nonketotic syndrome (HHNS),
multiple organ dysfunction syndrome Multiple organ dysfunction syndrome (MODS) is altered organ Organ may refer to: Biology * Organ (anatomy) An organ is a group of Tissue (biology), tissues with similar functions. Plant life and animal life rely on many organs that co-exist ...
,
urinary obstruction Urinary retention is an inability to completely empty the bladder. Onset can be sudden or gradual. When of sudden onset, symptoms include an inability to urinate and lower abdominal pain. When of gradual onset, symptoms may include urinary incont ...
/
urinary retention Urinary retention is an inability to completely empty the bladder. Onset can be sudden or gradual. When of sudden onset, symptoms include an inability to urinate and lower abdominal pain. When of gradual onset, symptoms may include loss of bladd ...

urinary retention
, diabetic ketoacidosis (DKA),
pre-eclampsia Pre-eclampsia is a disorder of pregnancy Pregnancy, also known as gestation, is the time during which one or more offspring In biology, offspring are the young creation of living organisms, produced either by a Asexual reproduction, si ...
, and
urinary tract infection A urinary tract infection (UTI) is an infection An infection is the invasion of an organism's body tissues by disease-causing agents, their multiplication, and the reaction of host A host is a person responsible for guests at an e ...
s, among other conditions. Beyond oliguria is
anuria Anuria is nonpassage of urine Urine is a liquid by-product A by-product or byproduct is a secondary product derived from a production process, manufacturing process or chemical reaction; it is not the primary product or service being produced. ...
, 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".


Definition

Oliguria is defined as a urine output that is less than 1 mL/kg/h in infants,Free Full Text
less than 0.5 mL/kg/h in children, and less than 400 mL or 500 mL
Last full review/revision March 2009 by Soumitra R. Eachempati
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.


Diagnostic approach

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 Perfusion is the passage of fluid through the circulatory system The circulatory system, also called the cardiovascular system or the vascular system, is an organ system An organ system is a biological system A biological system is a c ...
of the kidney (e.g. as a result of
dehydration In physiology, dehydration is a lack of total body water In physiology Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology Biology is the natural science that studies ...

dehydration
by poor oral intake,
cardiogenic shock Cardiogenic shock (CS) is a medical emergency resulting from inadequate blood flow due to the dysfunction of the ventricles of the heart.Textbooks of Internal MedicinHarrison's Principles of Internal Medicine 16th Edition, The McGraw-Hill McG ...
,
diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery defecation, bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration of ...
,
G6PD deficiency Glucose-6-phosphate dehydrogenase deficiency (G6PDD) is an inborn error of metabolism that predisposes to red blood cell breakdown. Most of the time, those who are affected have no symptoms. Following a specific trigger, symptoms such as yellowish ...
, massive
bleeding Bleeding, also known as a hemorrhage, haemorrhage, or simply blood loss, is blood Blood is a body fluid Body fluids, bodily fluids, or biofluids are liquid A liquid is a nearly incompressible In fluid mechanics or more generally ...

bleeding
or
sepsis Sepsis is a life-threatening condition that arises when the body's response to infection An infection is the invasion of an organism's body by , their multiplication, and the reaction of tissues to the infectious agents and the s they pr ...
) * Renal: due to kidney damage (severe
hypoperfusion Perfusion is the passage of fluid through the circulatory system The circulatory system, also called the cardiovascular system or the vascular system, is an organ system An organ system is a biological system A biological system is a c ...
,
rhabdomyolysis Rhabdomyolysis is a condition in which damaged skeletal muscle breaks down rapidly. Symptoms may include myalgia, muscle pains, weakness, vomiting, and mental confusion, confusion. There may be tea-colored urine or an arrythmia, irregular heartb ...
,
medication A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to medical diagnosis, diagnose, cure, therapy, treat, or preventive medicine, prevent disease. Drug therapy (pharmacotherapy) ...

medication
) * Postrenal: as a consequence of obstruction of the urine flow (e.g. enlarged prostate, tumour compression urinary outflow, expanding
hematoma A hematoma, also spelled haematoma, or blood suffusion is a localized bleeding Bleeding, also known as a hemorrhage, haemorrhage, or simply blood loss, is blood Blood is a body fluid Body fluids, bodily fluids, or biofluids are liquid ...

hematoma
or fluid collection)


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 Aldosterone is the main mineralocorticoid steroid hormone produced by the zona glomerulosa of the adrenal cortex in the adrenal gland. It is essential for sodium conservation in the kidney, salivary glands, sweat glands, and colon. It plays a cen ...

aldosterone
(Na and water retention) and
antidiuretic hormone Vasopressin, also called antidiuretic hormone (ADH), arginine vasopressin (AVP) or argipressin, is a hormone A hormone (from the Greek Greek may refer to: Greece Anything of, from, or related to Greece Greece ( el, Ελλάδα, , ...
(ADH) release


Babies

Oliguria, when defined as less than 1 mL/kg/h, in
infant An infant (from the Latin word ''infans'', meaning 'unable to speak' or 'speechless') is the more formal or specialised synonym for the common term ''baby'', meaning the very young offspring of human beings Humans (''Homo sapiens'' ...

infant
s is not attributed to kidney failure.


See also

*
Polyuria Polyuria () is excessive or an abnormally large production or of (greater than 2.5 L or 3 L over 24 hours in adults). Increased production and passage of urine may also be termed . Polyuria often appears in conjunction with (increased thirst) ...
(excessive urine production) *
Anuria Anuria is nonpassage of urine Urine is a liquid by-product A by-product or byproduct is a secondary product derived from a production process, manufacturing process or chemical reaction; it is not the primary product or service being produced. ...
(absolute lack of urine output) * Intraabdonmial hypertension (IAH) and Abdominal Compartment Syndrome (ACS)


References


External links

{{Urinary system symptoms and signs Symptoms and signs: Urinary system