Renal failure patients know that daily urine volume is important indicator of their illness conditions and they pay much attention to their urine output.
In case of oliguria (it means that reduction of 24-h urine volume to less than 400ml), they will feel nervous and scared. There are several causes of oliguria in renal failure and improper use of diuretics without making clear the exact cause has no curative effects at all and will instead worsen illness conditions, therefore it is necessary and scientific to first know what causes the decline of urine volume so as to take more targeted and effective treatments and measures.
Generally speaking, the causes of oliguria can be classified into 3 categories---pre-renal, renal and post-renal.
Pre-renal cause of oliguria
It is mainly due to hypovolemia (reduced blood volume). Long term poor appetite, low-salt diets, nausea, vomiting, diarrhea and over diuretics can all cause low blood volume and blood flow in the kidneys. This can cause reduction in urine volume. Treatment is to reduce dosage of diuretics, increase blood volume and blood supply to the kidneys.
Symptoms of hypovolemia include tachycardia, orthostatic hypotension, dry tongue and loss of elasticity of the skin, etc. These signs and illness history can help diagnose hypovolemia.
Renal cause of oliguria
This is due to progressive impairment of renal parenchyma and gradual worsening of renal functions. Urine volume will experience gradual decline and can even lead to no urine at all. At the same time, patients also have high serum creatinine and blood urea nitrogen levels, anemia will be worsened and it usually indicates poor prognosis. Doctors will suggest preparation for dialysis and kidney transplant.
Post-renal cause of oliguria
Post-renal causes of oliguria are mainly urinary tract obstruction and infections. In the early stage patients can have urinary frequency, urinary urgency and urinary pain and in the later stage urine volume will decrease and there will be abdominal distention and abdominal pain. Make clear the cause of urinary tract obstruction and remove the obstruction can help reverse renal damages.
Besides, dehydration can also cause reduction of urine output, the correct way is to have proper daily water intake according to the urine output.
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