The normal amount of daily urine output of 1500 ml. If the amount of daily urine is reduced to 400-500 ml, then this condition is called oliguria. The reason is to reduce oliguria filtration processes or increased reabsorption of urine in the kidney, i.e. oliguria it occurs due to urine production abuse disorders or urinary excretion.
Physiologic oliguria occurs at a general dehydration due to water starvation, profuse sweating, vomiting and diarrhea hurricane. The reason may be oliguria extensive burns, large blood loss, shock or collapse due to a sharp decrease in blood pressure. Increased production in the body of certain types of hormones (aldosterone, antidiuretic hormone) can also result in oliguria. A significant decrease in urine frequently observed in a variety of diseases of the kidneys.
Oliguria should be distinguished from acute urinary retention, in which the bladder is full, but the flow of urine does not occur due to the existing obstacles. Catheterization of the bladder, allowing to carry out accurate measurement of urine, is used for the diagnosis of oliguria.
For the treatment of oliguria is necessary to identify the initial cause of the condition. Of great importance is a detailed history and physical examination of the body. Effective screening methods for the study of the urinary system, such as ultrasound and radionuclide study. In the appointment of the doctor performed computed tomography, retrograde applied research methods or intravenous urography.
In urology, the following types of oliguria:
- orthostatic oliguria occur if the patient is in an upright position. It may be a symptom of portal hypertension; 2) extrarenal oliguria not associated with kidney disease. It can be a symptom of diseases of the cardiovascular system, liver, gastrointestinal tract, febrile conditions, eating disorders;
- emotional oliguria caused strong negative emotions;
- renal oliguria occurs in pathological changes in the kidney and is divided into prerenal, renal and postrenal.
- Urologist may suspect postrenal oliguria, if in the past the patient attended the stones in the kidneys, the ureters were identified disease or were retroperitoneal disease or tumors in the retroperitoneal space.
Prerenal oliguria often occurs due to insufficient perfusion of the kidneys, which leads to:
- reduce the volume of extracellular fluid due to sodium loss due to vomiting, diarrhea, excessive sweating, etc,
- a decrease in the circulating blood volume due to bleeding sepsis, hypoalbuminemia, and
- reduction in cardiac output due to abnormalities of myocardium, heart disease, pericarditis,
- kidney damage due to vascular pathologies of renal arteries, nephrosclerosis, vasculitis, etc.
Renal Oliguria accompanied by kidney disease (acute nephritis, tubular necrosis), poisoning nephrotoxic agents, disease of the cardiovascular system (systemic vasculitis, embolism, infective endocarditis). If the decrease in the amount of urine is compounded by the low density of urine, the situation requires an immediate examination and treatment. Therapy is appointed taking into account the causes of oliguria. General treatment of oliguria scheme is as follows: blocked pathogenic factor causing oliguria, restored the disturbed homeostasis and treat complications. It can be used hemodialysis or hemofiltration.
Prediction of the patient depends on the extent and origin of oliguria. Oliguria, which arose in patients with renal disease, is reversible if the patient receives timely and adequate treatment. Launched oliguria often goes to anuria. Postrenal oliguria after eliminating factors that prevent the outflow of urine, polyuria replaced.