eMedicine Specialties > Pediatrics: General Medicine > Nephrology

Oliguria: Follow-up

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, Chief Executive Officer of Dialysis Unit, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine
Contributor Information and Disclosures

Updated: Dec 3, 2008

Follow-up

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.

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

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.

Patient Education

 


More on Oliguria

Overview: Oliguria
Differential Diagnoses & Workup: Oliguria
Treatment & Medication: Oliguria
Follow-up: Oliguria
Multimedia: Oliguria
References
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References

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Further Reading

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Keywords

oliguria, acute renal failure, ARF, prerenal failure, small amount of urine, kidney disease, obstruction of the urinary tract, impaired renal function, nephrotoxins, interstitial nephritis, neonatal asphyxia, dehydration, renal hypoperfusion, acute tubular necrosis, hemolytic uremic syndrome, sepsis, bone marrow transplantation, renal insufficiency, diarrhea, diabetes insipidus, diabetes mellitus, nephrotic syndrome, streptococcal infection, postinfectious glomerulonephritis, systemic lupus erythematosus, sinusitis, Wegener granulomatosis, Goodpasture disease, hematuria, proteinuria, hypertension, hepatomegaly, gallop rhythm, pulmonary edema, encephalopathy, Henoch-Schönlein purpura, renal vein thrombosis, polycystic kidneys, multicystic dysplasia, hydronephrosis, respiratory distress syndrome, bladder outlet obstruction, neurogenic bladder, ureteral obstruction, salt-wasting nephropathy

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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, Chief Executive Officer 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.

Medical Editor

Laurence Finberg, MD, Clinical Professor, Department of Pediatrics, University of California at San Francisco and Stanford University
Laurence Finberg, MD is a member of the following medical societies: American Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

Managing Editor

Luther Travis, MD, William W Glauser Professor of Pediatrics and Pediatric Nephrology, Department of Pediatrics, Divisions of Nephrology and Diabetes, University of Texas Medical Branch and Children's Hospital
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.

CME Editor

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, Feinberg School of Medicine, Northwestern University; Division Head of Kidney Diseases, Children's Memorial Hospital, Chicago
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: Amgen Grant/research funds None; Abbott Honoraria Speaking and teaching; Altus Pharmaceuticals Grant/research funds None; Genzyme Grant/research funds None; Merck Grant/research funds None; NIH Grant/research funds None

 
 
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