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Staging of Kidney Failure according to Urine Volume

2012-12-31 15:40

24-h urine volume is important for renal failure patients and it is especially true for end stage renal failure patients. Urine is often hope for end stage patients that have taken years dialysis and urine means that there are still functional renal units.

Kidney failure can be divided into 3 stages according to daily urine output---oliguria period, diuresis period and convalescence.

Oliguria period

It is the most serious stage and there are serious internal disorders. Patients can have a series of abnormalities and changes in urine like oliguria (less than 400ml/d) or even anuria (less than 100ml/d), low specific gravity urine (1.010-1.020), high urine sodium, blood in urine, bubbles in urine, cylindruria, etc.

In serious cases patients will have water poisoning, hyperkalaemia, metabolic acidosis and azotemia. Metabolic acidosis can lead to high serum potassium level which is often the cause of death. And progressive worsening of azotemia will lead to uremic state and pose great threaten to patients’ life.

This stage can last for days to weeks. The longer it lasts, the poorer the prognosis is. Therefore timely and proper treatment is necessary.

Diuresis period

After the oliguria period, urine volume will gradually increase and it enters into diuresis period when daily urine output exceeds 500ml and then it will gain fold increase day by day and the highest urine volume can be up to 3000-6000ml or even above 10000ml.

At the early stage of diuresis, there are still metabolic accumulation in the body due to low renal clearance rate. After about 4-5 days, serum creatinine and urea will decrease with increase urine output and the uremic states will be improved also. Diuresis can cause dehydration and loss of large amount of potassium, sodium, chloride and other electrolytes.

This stage will last 1-2 weeks.

Convalescence

24-h urine volume will return to normal and renal functions will recover after 3-12 months. In most cases, renal functions can be recovered to normal and only few will turn into chronic renal failure.

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