Normally, every healthy person within a day is allocated about one and a half liters of urine. More accurate volumes depend on the age and sex characteristics, as well as the daily amount of liquid drunk. If diuresis is not more than a half liter, then we are talking about the development of oliguria.
Oliguria - what is this?
The decrease in the daily excretion of urine, which is called oliguria, is not classified by experts as an independent pathology, but as a symptomatic manifestation indicating the presence of urinary or renal pathology. A similar syndrome occurs in patients of any age and gender. But in adults this phenomenon is more common, because in children the smaller volumes of urine are the norm. Usually in the heat or when working in high-temperature conditions there is an increase in sweating, accordingly diuresis decreases, but this phenomenon is not considered a pathology, because it passes by itself.
In pregnancy, tissues become more hydrophilic, i.e., are prone to increased fluid uptake. Do not confuse small volumes of urine with incomplete emptying, which occurs due to the pressure of the enlarged uterus on the ureters, making it difficult to remove urine. Such a case is characterized not by a reduced volume of daily urine, but by difficulties in its derivation.
Pathogenesis of
During oliguria, the patients undergo a reduction of the excreted urine. Such a factor is often confused with difficulty urinating arising from functional disorders in the bladder. On the emergence of oliguria says a rare desire to go to the toilet. For a day in a patient suffering from oliguria only 400-500 ml of urine is released, while the average daily rate is three times higher.
In addition, oliguria should be distinguished with a delay in urinary excretion, which is also associated with vesicidal disorders. Very often oliguria is accompanied by nocturia, for which frequent walking to the toilet at night is characteristic.
Causes of
Oliguria can occur on a background of cardiovascular, gastrointestinal and renal pathologies.
In addition, urine volumes can be reduced in the presence of such conditions as:
- Reduced pressure level;
- Intoxication of the body;
- Pathologies of the nephrological sphere;
- Copious blood loss;
- Fasting.
If there is no discomfort with an empty bladder, then you should not worry. Perhaps the causes of a decrease in urine are hidden in a hot environment, when a large amount of fluid is removed with sweat. In addition, the amount of urine is affected by the amount of urine consumed. If you did not eat broths and soups for a day, did not drink any drinks, then there will be little urine. The reason for going to the doctor is to keep this state for several days.
In women, the pathological decrease in urine is more often caused by:
- Hormonal imbalance in pregnancy;
- Age changes;
- Urinary atony, arising against a background of stresses and inflammatory processes.
In men, oliguria usually occurs due to tumor processes, enlargement or inflammation of the prostatic tissue, narrowing of the urethra, prostate adenoma or benign formations in the urogenital system. Emptying the bladder in a similar situation is accompanied by pronounced soreness. In children, the causes of oliguria are similar to adults. There are a lot of similar reasons, therefore doctors classify them into several groups: renal and prerenal, postrenal and transient.
Prerenal
To the group of prerenal causes include those conditions in which too little fluid passes through the kidney structures, which leads to an insufficient volume of daily urine.
Similar characteristic:
- With severe vomiting;
- Prolonged diarrhea;
- Large blood loss;
- Elevated temperature;
- Loss of a large volume of fluid, for example, with profuse sweating;
- Severe burns;
- Myocardial insufficiency;
- Diuretic drug abuse.
The main factors that cause prerenal oliguria are dehydration, a decrease in pressure and renal blood flow, i.e., causes not related to kidney pathologies.
Renal
The causes of the renal group are based on various manifestations associated with impaired renal activity, which often leads to the development of kidney failure of a chronic or acute nature. This includes:
- Vascular pathologies like systemic vasculitis or scleroderma;
- Diseases of tubulointerstitial type, for example, acute interstitial nephritis or tubular necrosis of acute form;
- Pathologies of glomerular origin, such as systemic etiology or glomerulonephritis nephritis.
The category of renal factors provoking oliguria also includes kidney trauma, nephrotoxic effects associated with the use of X-ray contrast, sulfanilamide or antibiotic group, nephrotic syndrome, etc.
Emergency
The causes of this group are associated with pathological disorders in the urinary tract.
Most often they consist in:
- Reduced urethral lumen;
- Renal conglomerates;
- Blockage of the urethra canal by tumor formation, blood clot or calculus;
- Cancer of the urinary tissues.
Most often postrenal oliguria is typical for men suffering from prostatitis or pregnant patients.
Transient
Transient oliguria occurs in newborns, refers to the borderline states that form in the child in the first 3 days of life. Usually this condition is a physiological reaction lasting not more than a month, but if the principles of care, adaptive abilities of the child's organism are violated, unfavorable environmental conditions take place, then such a reaction can go into a pathological condition requiring treatment.
With transient oliguria, occurring approximately 2-3 days after birth, there is a sharp decrease in excreted urine. The reason for this condition experts call the lack of intake of fluid in the body, due to the fact that lactation begins in a woman a few days after childbirth. The cause of transient oliguria is also the hemodynamic features of newborns.
Signs and symptoms
The main feature of oliguria is a marked decrease in daily urine to 400-500 ml. Such a symptom can be supplemented by signs of the disease, against which the formation of the oliguria syndrome occurred. If you want to go to the toilet rarely, but there is no discomfort, the reasons for this condition can be associated with heat and excessive sweating.
If the symptoms of a decreased urine output are disturbing for several days, there is a need for an urgent visit to the nephrologist. For oliguria, caused by a violation of renal activity, there is an increase in urine levels of erythrocytes, renal epithelium, leukocytes and protein.
Diagnosis
Diagnostic studies in oliguria are based on the collection of anamnesis and physical examination. If the patient has previously had cases of retention of the urinary tract or urolithiasis, then an oliguria of postrenal origin is suspected.
Usually diagnostic diagnoses are used for the final diagnosis, such as:
- Ultrasound examination of renal structures;
- Radionuclide diagnosis of the urinary system and kidney;
- Computed tomography using contrast;
- Laboratory testing of urine, blood, etc.
The more diagnostic procedures will be used, the more accurate the diagnosis will be. Oliguria is often confused with genitourinary pathologies, because this syndrome is often combined with them. Therefore, special attention is paid to diagnostics.
Treatment of
The treatment process for oliguria includes several purposes:
- Eliminate provoking factors and relieve the patient of the syndrome;
- Correct the balance in the body and restore blood circulation;
- Avoid possible complications and subsequent relapses.
The liver of medications used is determined in accordance with the etiology of oliguria. Usually, daily urine volumes are restored soon after the root cause of the syndrome has been eliminated. If oliguria is of infectious origin, then they resort to antibiotic therapy.
If the oliguria occurred on the background of pyelonephritis or glomerulonephritis, the treatment includes not only taking drugs, but also strict diet therapy. In any case, oliguria is a reversible process, but if you do not start timely treatment, complications such as anuria may develop, when urine is absent altogether. Therefore, if there is a suspicion of the development of abnormalities, it is necessary to undergo a urological examination.