Anuria

Introduction 24-hour urine volume less than 100 ml or closed urine, seen in patients with severe heart and kidney disease and shock. In the oliguria period of epidemic hemorrhagic fever, the urineless standard is 24 hours urine volume less than 50 ml.

Cause

Divided into pre-renal, renal and post-renal. Prerenal: Shock, heart failure, dehydration, and other conditions that cause an effective blood volume reduction can result in glomerular filtration and anuria. Renal: caused by substantial changes in various kidneys. Post-renal: due to calculi, urinary tract stenosis, tumor compression caused by urinary tract obstruction or dysuria.

an examination

Related inspection

Ultrasonic examination of the bladder, routine urine angle measurement, urethral lift test

Dehydration caused by various causes such as severe diarrhea, vomiting, and blood concentration caused by extensive burns. 2 major blood loss, shock, cardiac insufficiency, etc., decreased blood pressure, decreased renal blood flow or renal ischemia caused by renal vascular stenosis. 3 severe liver disease, systemic edema caused by hypoproteinemia, and reduced effective blood volume. 4 When severe trauma, infection and other stress states, sympathetic nerve excitability, adrenal cortex hormones and antidiuretic hormone secretion may be added to increase renal tubular resorption and cause oliguria. 24-hour urine volume less than 100 ml is called anuria or closed urine, seen in patients with severe heart, kidney disease and shock

Differential diagnosis

Prerenal oliguria is generally caused by insufficient perfusion, and its identification with renal: in prerenal oliguria, the renal tubules maintain a good concentration and reabsorption of sodium. Therefore, oliguria combined with low urinary sodium, urinary sodium <20mmol / L, and hypertonic urinary > 500mOsm / L, and tubular necrosis, renal tubular concentration and reabsorption function decreased, so oliguria with high urine sodium "40mmol / L and hypotonic urine, but this is not an absolute clinical and many pre-renal manifestations of concentrated hypernatremia. It can also be identified by both rehydration and diuretic methods. The urine volume and renal function of the prerenal sex will be improved after rehydration, and the urine volume will increase after diuresis; while the renal replenishment does not relieve, the diuretic effect is not strong. The results of post-renal urine routine findings of red blood cells and protein, urinary color ultrasound showed a lesion.

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