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