Under normal conditions, the urine produced and excreted over the course of 24 hours is between 1 and 2 liters. When, on the other hand, the quantity is lower than this limit, a clinical condition is revealed which takes the name of oliguria , a term that means an emission reduced to the point of being less than 400 milliliters over 24 hours in an adult subject.
This amount is obviously lower for children, and is calculated as 0.5 milliliters / kg / height.
It is a condition opposite to polyuria , in which there is a considerable increase in the volume of urine produced, but also different from anuria, a condition that instead indicates a drastic reduction in the urine expelled, for a quantity of less than 50 mL per day.
An episode of oliguria must always be taken into serious consideration and must always be evaluated by your GP, as it could be the symptom of a serious clinical condition.
Obviously, a reduction in the volume of urine does not always have a pathological significance, in fact in most cases it is a sporadic phenomenon without associated symptoms and of a short duration (1-2 days). In these cases, the blame is usually attributed to a condition of dehydration, therefore, by restoring the correct intake of fluids in the body, the problem is solved without leaving consequences of great entity.
When the decrease in urine lasts for several days, if the phenomenon recurs frequently and if the disorder is associated with other symptoms such as fever , burning in the urinary tract , pain , nausea , vomiting , sweating , generalized malaise, and it is necessary to contact expeditiously to your doctor and undergo the preliminary investigations.
What are the main causes of oliguria
The main clinical conditions that can cause decreased urine production (oliguria) are the following. I remember that these are the conditions that statistically occur with a greater frequency but each case must be strictly evaluated by the doctor.
Dehydration
This is undoubtedly the most common cause of oliguria , frequent during the summer, when you lose a lot of fluids with sweat, in case of diarrhea, intense physical activity, fever and vomiting. In fact, when a lot of fluids are lost without then integrating them again, there is a consequent limited urine production.
If not taken to the limit, it is a reversible condition: once an adequate quantity of liquids is reintroduced, the normal volume of urine produced is restored. This is why it is important to drink at least 1.5 liters of water a day, increasing the altitude based on climatic conditions, sweating, and sudden events such as fever, vomiting and diarrhea.
In these cases, if the oliguria is limited within 1-2 days, there is no need to be alarmed, but if it lasts longer it is necessary to contact your general practitioner quickly.
Urinary tract obstruction
Urine is transported from the kidneys to the bladder via the ureters. This pathway can sometimes be blocked by kidney stones, which are also often the result of a low intake of fluids in the body, which leads to a blockage in the urinary tract, therefore in the renal pelvis, ureters, bladder or urethra. .
In case of kidney stones there are very acute symptoms such as intense and stabbing pain, vomiting, profuse sweating, fever, swelling and swelling and more nausea. In case of obstruction it is necessary to consult a doctor quickly, but fortunately in most cases the symptoms are so intense as to induce the person concerned to promptly go to an emergency room.
Another example of obstruction is due to prostatic hypertrophy or inflammation of the prostate (prostatitis).
Kidney failure
It is a condition that occurs when the kidneys are unable to perform the task of regulating the hydro-saline balance of the body and eliminating waste and protein breakdown products from the blood. Renal failure can occur in a short time (acute) in case of haemorrhages, shock, severe states of dehydration, heavy metal intoxication, infections and again as a possible consequence of taking chemotherapy drugs or antibiotics. However, renal failure can also be chronic, a condition that occurs over a prolonged period of time and following clinical conditions such as diabetes, hypertension, atherosclerosis, kidney infections and inflammation.
Trauma and infections
These are serious conditions that require the utmost promptness in seeking medical advice. Both in the case of severe trauma and infections, the body can undergo a state of hypovolemic shock, a condition that compromises the correct supply of blood to tissues and organs, with serious repercussions on their functionality.
Drugs Oliguria can
be the consequence of taking drugs such as non-steroidal anti-inflammatory drugs (NSAIDs ), antibiotics (e.g. gentamicin) or ACE inhibitors ., prescribed to patients with hypertension. In the event that a reduced emission of urine occurs following or in conjunction with the intake of a drug, it is necessary to inform your doctor of the problem, without acting on your own or taking the initiative to stop taking the drugs .
What to do in case of oliguria
Given the severity of some clinical conditions that can give oliguria as the main premonitory symptom, the following precautions are reiterated:
- if the problem persists for more than 1-2 days;
- if the symptom occurs frequently;
- if it is associated with other disorders such as pain, fever , swelling, widespread malaise, dizziness ;
It is necessary to seek medical advice as quickly as possible, avoiding taking actions based on your beliefs or on the advice of people who are not qualified to provide you with medical support. Oliguria can
be a symptom that precedes conditions of great clinical importance, therefore early intervention is necessary to avoid serious damage that leads to renal failure .
Furthermore, oliguria can be the antechamber for the development of anuria (absence of the emission of urine, or in any case reduced to below 50 mL over the course of 24 hours), a condition that requires prompt medical intervention . Diagnosis and treatment of oliguria
When contacting the doctor it is important to report all the symptoms felt, the duration of the problem and whether it has occurred several times. It is equally important to tell your doctor if any members of your family have suffered from kidney, heart or metabolic diseases such as diabetes. In addition, the drugs taken also play a fundamental role, so during the medical examination you must not neglect to inform the doctor of all the drugs you are taking and in what dosage.
Among the diagnostic tests useful to identify the cause of the problem, the most common are:
- blood test to evaluate serum levels of sodium, potassium, phosphate and calcium . And again the values ​​of serum creatinine and the level of urea nitrogen (Blood Urea Nitrogen or BUN);
- blood gas analysis (EGA) from which to derive the acid-base balance;
- urinalysis ;
- ultrasound of the abdomen and kidneys .
The therapeutic strategy obviously depends on the triggering cause of the oliguria and in any case it must be indicated and prescribed by a doctor after a careful evaluation of the case, therefore it is necessary to avoid putting into practice any type of indication found on the web or suggestions from acquaintances. who are not doctors.
In the case of severe dehydration , the patient is generally rehydrated by intravenous infusion of physiological solution to which pharmacological treatments can be added depending on the case, such as antibiotics in a subject who has an infection or who has undergone a ‘ burn.
If the problem is due to renal failure, in addition to pharmacological treatments, there may also be the need to subject the patient to dialysis, in order to eliminate toxins and waste substances in the blood that the kidney is no longer able to filter.
In case of diarrhea or fever , in addition to rehydration, it is also necessary to provide for the integration of lost mineral salts .
Main sources
- MedScape: https://emedicine.medscape.com/article/983156-overview
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