Symptom / Sign: Oliguria
Classifications and external resources

ICD-10	R34.
ICD-9	788.5

Oliguria and anuria are the decreased or absent production of urine, respectively. The decreased production of urine may be a sign of dehydration, renal failure or urinary obstruction/urinary retention.

Definition

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/day (equals 17mL/hour) in adults.^[1]

Pathophysiology

The pathophysiologic 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, diarrhea, 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)

Postoperative oliguria

Patients usually have 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 in infants

Oliguria, when defined as less than 1 mL/kg/h, in infants is not considered to be a reliable sign of renal failure.^[2]

References

1. ^ Klahr S, Miller S (1998). "Acute oliguria". N Engl J Med 338 (10): 671–5. doi:10.1056/NEJM199803053381007. PMID 9486997.  Free Full Text.
2. ^ Arant B (1987). "Postnatal development of renal function during the first year of life". Pediatr Nephrol 1 (3): 308–13. doi:10.1007/BF00849229. PMID 3153294. 

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