What Is Oligomenorrhea?

Oligoria refers to a urine output of less than 400 ml per hour or less than 17 ml per hour. It is found in acute nephritis, major blood loss, excessive secretion of antidiuretic hormones and aldosterone, renal artery compression by tumors, diarrhea, vomiting, Patients with severe sweating, heart failure, and shock. Treatment needs to address the cause: prerenal volume expansion; renal administration to improve renal circulation and removal of inducing factors; postrenal administration to relieve obstruction and other treatments. Symptomatic treatment: maintain electrolyte balance, nutrition support and other treatments.

Basic Information

English name

Oliguria

Visiting department

Nephrology

Common causes

Acute nephritis, major blood loss, excessive secretion of antidiuretic hormones and aldosterone, renal artery compression by tumors, diarrhea, vomiting, sweating, heart failure, and shock, etc.

Common symptoms

24 hours urine output less than 400 ml, or hourly urine output less than 17 ml

Causes of oliguria and common diseases

Prerenal

(1) Reduced effective blood volume Shock, severe dehydration, major hemorrhage, nephrotic syndrome, and hepatorenal syndrome caused by large amounts of water to penetrate into the interstitial space and serosal cavity caused by multiple causes, reduce blood volume, and reduce renal blood flow.

(2) Cardiac insufficiency caused by various reasons of decreased blood output from the heart, severe arrhythmia, and unstable systemic circulation after cardiopulmonary resuscitation. Reduced renal blood flow due to decreased blood pressure.

(3) Renal vascular disease Renal vascular stenosis or inflammation, nephrotic syndrome, lupus nephritis, renal artery embolism and thrombosis caused by prolonged bedriding; Hypertension crisis, pregnancy-induced hypertension, etc. cause persistent renal artery spasm and renal deficiency Blood causes acute renal failure.

2. Renal

(1) Glomeropathy Lesion Acute Nephritis and Chronic Nephritis due to severe infection, continuous increase in blood pressure or renal toxicity caused by sharp deterioration of renal function.

(2) Acute interstitial nephritis of renal tubular disease includes drug-induced and infectious interstitial nephritis; acute tubular necrosis caused by biological or heavy metal and chemical poisoning; severe pyelonephritis with renal papillary necrosis.

3. Postrenal

(1) Mechanical urinary tract obstruction such as stones, blood clots, necrotic tissue obstructing the ureter, bladder entrance or posterior urethra.

(2) External urinary pressure such as tumor, retroperitoneal lymphoma, idiopathic retroperitoneal fibrosis, and prostate hypertrophy.

(3) Other ureteral surgery, scar contracture after tuberculosis or ulcer healing, severe renal sagging or renal torsion caused by swimming kidney, neurogenic bladder, etc.

Oliguria test

Check-up

Pay attention to dehydration, blood pressure, and peripheral circulation perfusion. Lower urinary tract obstruction focuses on examining the prostate, bladder volume, and palpation of the kidney.

2. Laboratory inspection

The urine volume should be recorded daily, and the relative density of routine urine should be repeatedly checked to help diagnose the substantial renal damage, renal failure, and judgment of dehydration. Blood routine red blood cell volume is a powerful judgement of blood volume and subclavian puncture test if necessary Central venous pressure is more reliable in judging blood volume; blood biochemical examination includes examination of renal function, acid-base balance, and electrolytes. Routine DIC examination should be performed when disseminated intravascular coagulation is suspected.

3. B-ultrasound, CT, MRI examination

It is of great help in determining stone tumors, prostate hypertrophy, hydronephrosis and tuberculosis.

Differential diagnosis of oliguria

1. Oliguria with renal colic is seen in renal artery thrombosis or embolism, and kidney stones.

2. Oliguria with palpitations, shortness of breath, chest tightness can not lie supine, see cardiac insufficiency.

3. Oliguria with a large amount of proteinuria, edema, hyperlipidemia and hypoproteinemia are seen in nephrotic syndrome.

4. Oliguria accompanied by fatigue, poor appetite, ascites, and yellowing of the skin are seen in hepatorenal syndrome.

5. Oliguria with hematuria, proteinuria, hypertension, and edema are seen in acute nephritis and progressive nephritis.

6. Oliguria is accompanied by fever, low back pain, frequent urination, urgency, and dysuria seen in acute pyelonephritis.

7. Oliguria with dysuria is seen in prostatic hypertrophy.

Principles of oliguria treatment

General processing

Bed rest, proper diet, low salt protamine diet for those with renal insufficiency.

2. Cause treatment

Prerenal expansion: Renal administration improves renal circulation and removes inducing factors; postrenal sex usually asks surgeons for treatment such as obstruction removal.

3. Symptomatic treatment

Treatments such as maintaining electrolyte balance and nutritional support.

4.Incoming and outgoing monitoring

ECG monitoring is required when vital signs are unstable.