Oliguria Follow-up

  • Author: Prasad Devarajan, MD; Chief Editor: Craig B Langman, MD   more...
 
Updated: Nov 22, 2011
 

Transfer

If the patient with oliguria requires close monitoring of hemodynamic status or if indications for acute dialysis are present, transfer the patient to a center with ICU facilities.

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Complications

Infections develop in 30-70% of patients and affect the respiratory system, urinary tract, and indwelling catheters. Impaired defenses due to uremia and inappropriate use of antibiotics may contribute to the high rate of infectious complications.

Cardiovascular complications are a result of fluid and sodium retention. They include hypertension, congestive heart failure, and pulmonary edema.

Hyperkalemia results in ECG abnormalities and arrhythmias.

Other complications include the following:

  • GI - Anorexia, nausea, vomiting, ileus, and bleeding
  • Hematologic - Anemia and platelet dysfunction
  • Neurologic - Confusion, asterixis, somnolence, and seizures
  • Other electrolyte/acid-base disorders - Metabolic acidosis, hyponatremia, hypocalcemia, and hyperphosphatemia
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Prognosis

Despite significant advances in supportive care and renal replacement therapy, high mortality rates in the setting of multiorgan failure have not significantly improved in the past few decades.

Patients die with renal failure; however, they do not die not because of renal failure. The patient succumbs because of involvement of other systems during the period of renal insufficiency. Oliguric acute renal failure is an independent risk factor for mortality, as well as for nonrenal complications.

On the other hand, prognosis from prerenal causes or from acute tubular necrosis in the absence of significant comorbid conditions is usually quite good if appropriate therapy is instituted in a timely fashion.

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Patient Education

For excellent patient education resources, see eMedicine's Diabetes Center. Also, visit eMedicine's patient education articles Acute Kidney Failure and Chronic Kidney Failure.

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Contributor Information and Disclosures
Author

Prasad Devarajan, MD  Louise M Williams Endowed Chair in Pediatrics, Professor of Pediatrics and Developmental Biology, Director of Nephrology and Hypertension, Director of Clinical Nephrology Laboratories, CEO of Dialysis Unit, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine

Prasad Devarajan, MD is a member of the following medical societies: American Heart Association, American Society of Nephrology, American Society of Pediatric Nephrology, National Kidney Foundation, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Specialty Editor Board

Laurence Finberg, MD  Clinical Professor, Department of Pediatrics, University of California, San Francisco, School of Medicine and Stanford University School of Medicine

Laurence Finberg, MD is a member of the following medical societies: American Medical Association

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Luther Travis, MD  Professor Emeritus, Departments of Pediatrics, Nephrology and Diabetes, University of Texas Medical Branch School of Medicine

Luther Travis, MD is a member of the following medical societies: Alpha Omega Alpha, American Federation for Medical Research, International Society of Nephrology, and Texas Pediatric Society

Disclosure: Nothing to disclose.

Howard Trachtman, MD  Program Director, Pediatrics Research, Schneider Children's Hospital, Department of Pediatrics, Division of Nephrology, Professor, Albert Einstein College of Medicine

Howard Trachtman, MD is a member of the following medical societies: American Society of Hypertension, American Society of Nephrology, American Society of Pediatric Nephrology, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Chief Editor

Craig B Langman, MD  The Isaac A Abt, MD, Professor of Kidney Diseases, Northwestern University, The Feinberg School of Medicine; Division Head of Kidney Diseases, Children's Memorial Hospital

Craig B Langman, MD is a member of the following medical societies: American Academy of Pediatrics, American Society of Nephrology, and International Society of Nephrology

Disclosure: NIH Grant/research funds None; Raptor Pharmaceuticals, Inc Grant/research funds None; Alexion Pharmaceuticals, Inc. Grant/research funds None

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Pathogenesis of prerenal failure.
Compensatory mechanisms for preventing a fall in glomerular filtration rate (GFR) in the presence of prerenal failure.
Mechanisms of intrinsic acute renal failure.
 
 
 
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