Oliguria: What you need to know

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Oliguria is when urine output is lower than expected. Dehydration, a blockage, or drugs are the most common causes.

Oliguria may usually be treated at home, but it can also be an indication of a serious medical condition that needs more testing and treatment.

Oliguria is distinct from anuria, which occurs when urine production entirely ceases.

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Symptoms

The major sign of oliguria is a decrease in urine production. Depending on the reason of the reduction, people may also suffer various symptoms.

The following are the major signs and symptoms of oliguria:

  • Urinate less frequently and/or produce less urine than normal.
  • Urine that has a darker color of blue than usual (generally a deeper yellow color such as amber).

If there is red or dark red blood in the urine, this is referred to as hematuria.

Oliguria can lead to renal damage if left untreated.

Causes

Oliguria can be caused by a variety of factors, including dehydration, obstructions, and medications.

Dehydration

Dehydration is the most prevalent cause of oliguria. When your body doesn’t have enough water or fluids, it’s called dehydration, and it happens when you lose more than you take in. When you sweat a lot on a hot day or have a stomach ailment that causes diarrhea or vomiting, this might happen.

Blockage

Urine production can also be reduced when anything physically blocks the urinary system (such as an enlarged prostate or kidney stones), preventing urine from flowing freely.

The kidneys, ureters, and other parts of the urinary system can get blocked (tubes draining the kidney, bladder, and the urethra, which drains the bladder). Adults are more likely to have them than youngsters.

Medications

Some drugs might make it difficult for the body to generate or discharge urine:

  • Anticholinergics are drugs that prevent involuntary muscle movements and other biological processes. They’re used to treat a range of ailments, including Parkinson’s disease, gastrointestinal problems, and overactive bladder.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs) are medications that are used to decrease swelling and discomfort. Ibuprofen and aspirin are two examples.
  • Diuretics are drugs that cause the body to produce and excrete more pee. Diuretics, when taken in excess or for an extended period of time, can cause dehydration, renal damage, or other health problems, resulting in a reduction in urine output.
  • Some antibiotics, such as ciprofloxacin and penicillin, might damage the kidneys, resulting in decreased urine flow. This is especially prevalent in young children or people who have a chronic illness.

Other causes

Other factors can also induce a reduction in urine flow, however they are less prevalent. These are some of them:

  • Physical trauma
  • Shock
  • Substantial blood loss
  • Serious infections

Diagnosis

Oliguria is usually detected through a medical examination. Further testing to identify probable causes or check for linked health conditions may be required by healthcare providers.

Physical Examination

Your healthcare practitioner will likely ask you a number of questions about your health during your session to get a better sense of what’s causing the reduction in urine production. They’ll look for indicators of dehydration or a blockage in the urinary tract, such as discomfort in the lower abdomen (bladder) or flank (kidneys).

The volume of urine you generate in a day is used by doctors to diagnose oliguria, albeit the criteria for adults and children are different:

  • Adults: Less than 500 milliliters of urine in a 24-hour period2
  • Children: Less than 500 milliliters/1.73 square meter in a 24-hour period
  • Infants: Less than 0.5 milliliters/kilogram per hour in a 24-hour period

Other Tests 

More tests may be ordered by your doctor to identify what caused the reduction in urine flow and whether it has harmed your kidneys. These testing might include the following:

  • Urine tests: Urinalysis and urine culture are used to screen for infection. Additional kidney function tests include 24-hour urine testing, which involves collecting and analyzing urine at home over a one-day period.
  • Ultrasound or CT scan of the abdomen: To check for an obstruction, such as dilation of kidney (hydronephrosis)
  • Blood tests: To check your electrolytes, blood count, or kidney function
  • Cystoscopy: A procedure by a urologist that involves using a small camera scope to see inside the bladder

Treatment

The treatment for oliguria is determined by a number of criteria, including the patient’s general health, the likely reason of the reduction in urine, and whether or not the kidney has been injured.

Increasing your fluid intake, quitting drugs that may be aggravating the problem, and/or taking medications to address the problem are all common recommendations from healthcare experts.

Increasing Fluid Intake

Increasing the amount of fluids you consume is a straightforward technique to cure oliguria. This may usually be accomplished at home by drinking extra water or using electrolyte-based rehydration treatments.

Your doctor may suggest intravenous (IV) fluids and maybe hospitalization in situations of severe dehydration or when another health problem is present.

Medications

If rehydration isn’t enough—or if you have other health problems that are influencing your urine production or hydration levels—your doctor may prescribe drugs to address oliguria or its underlying cause.

Oliguria is treated with the following medications:

  • Antimicrobials: Infections that produce severe diarrhea or vomiting are treated with antibiotics.
  • Diuretics: Which force the body to produce more urine. In small amounts, diuretics can help increase urine output, but as noted above, too much can backfire and make oliguria worse.
  • Renal-dose dopamine: A somewhat debated treatment used to prevent kidney injury by expanding arteries in the kidney and increasing urine output

Prevention

Because dehydration is a common cause of oliguria, getting adequate water is one of the best strategies to avoid it. The amount of fluid you need to drink is determined by how much you’re sweating or unwell, as well as your general diet.

There is no one-size-fits-all set of standards for how much water a person should drink every day, contrary to health food blogs and conventional knowledge. However, the Institute of Medicine has guidelines for how much fluid you should drink on a daily basis, including fluids from meals and non-water beverages.

According to the National Institutes of Health:

  • Women should get 2.7 liters (or roughly 11.4 cups) of fluids per day.
  • Men should get 3.7 liters (or roughly 15.6 cups) of fluids per day.

When to see a doctor

If you also experience any of the following symptoms, you should see your doctor right away since a rapid reduction in urine production might be an indication of a significant medical problem:

  • Vomiting, diarrhea, or otherwise can’t seem to hold fluids
  • Racing heart
  • Dizziness
  • Feeling lightheaded

Sources:

  • https://www.merckmanuals.com/professional/critical-care-medicine/approach-to-the-critically-ill-patient/oliguria
  • https://medlineplus.gov/ency/article/003147.htm
  • https://doi.org/10.12861/jrip.2015.12
  • https://www.verywellhealth.com/oliguria-overview-4783466
  • https://pediatriccare.solutions.aap.org/chapter.aspx?sectionid=135886231&bookid=1626
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3728808/
  • https://www.nal.usda.gov/sites/default/files/fnic_uploads/water_full_report.pdf