Oliguria/Anuria
Suggested approach and Clinical Pearls
- Oliguria is often a contextual diagnosis
- Becomes a concern in UO<0.5mL/kg/h
- May reflect an undiagnosed underlying shock state
- Depends on chronicity of kidney injury or disease
- May reflect an appropriate ADH response after surgery
- Anuria may be temporary and remediable problem
- Blocked catheter or urinary system
- Recovering acute kidney injury
- Assess oligo-anuria with this framework
- pre-renal (circulation)
- intra-renal (medications and medical illness)
- post-renal perspective (urology, catheter)
- Treatment should be aimed at
- Correction of underlying problem at level of injury in the framework
- Supportive care to allow:
- Prevention of life-threatening complications
- Renal recovery
- Renal replacement therapy should be considered if:
- Uraemia with significant neurological or serosal complications
- Severe acidosis (pH<7.25)
- Life-threatening hyperkalaemia
- Significant fluid overload symptoms
- Dialyzable medication excessive effect