Oliguria with tachypnea

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Abbreviations: ABG = Arterial blood gases, BUN = Blood urea nitrogen, CBC = Complete blood count, CT = Computed tomography, CRP = C - reactive protein, ECG = Electrocardiogram, ESR = Erythrocyte sedimentation rate, IVP = Intravenous pyelography, KFT = Kidney function test, GI = Gastrointestinal, GFR = Glomerular filtration rate, MRI = Magnetic resonance imaging, PT = Prothrombin time

Etiology Clinical manifestations Paraclinical findings Comments
Symptoms and signs Lab findings Imaging
Fatigue/

Lethargy

Thirst Dizziness/

Confusion

Muscle weakness/

cramp

Somatic/

visceral pain

Vomiting Diarrhea Tachypnea Edema Blood indices Renal Funtion test Electrolytes Urine analysis ABG Other Ultrasound X-ray CT MRI Other
Prerenal causes Aspergillosis[1][2] +/- - - - - - - +/- - Not applicable Not applicable Not applicable Not applicable Not applicable Allergy test, ↑IgE (>1000 IU/dl), Direct visualization of fungal hyphae Not applicable Pulmonary infiltrates, Mucus plug, Mass in the upper lobe surrounded by a crescent of air, Solitary or multiple cavities Halo sign, Wedge-shaped pulmonary infarction, Granuloma Not applicable - Polymerase chain reaction (PCR)
Drugs/toxins[3][4] +/- +/- +/- +/- +/- +/- +/- +/- +/- Not applicable ↑BUN, ↑Cr, ↑CK ↑K, ↓Mg, ↓Ca, ↓P Ingested drug, Glucose, Aminoacid, Phosphate, Ketone, Hyaline cast, RBC ↑Lactate, Metabolic acidosis Toxicology, Rapid immunoassay Nephropathy Radioopaque substances, Ingested drug packets Not applicable Not applicable - -
Heart disease[5][6] +/- - - - - - - +/- +/- ↑ESR and CRP ↑BUN, ↑Cr Not applicable Not applicable Not applicable Throat culture, Rapid streptococcal antigen test, Hyperoxia test, Pulse oximetry Not applicable Cardiomegaly, Dextrocardia Not applicable Not applicable Ventricular dysfunction, Left and right ventricular hypertrophy, Valvular disease in echocardiography -
Ischemic cardiomyopathy[7][8] +/- - - - - - - +/- +/- Anemia ↑Cr ↓Na, ↓K, ↓Mg Not applicable Not applicable Troponin, Creatine kinase, Creatine kinase - MB, BNP Not applicable Abnormal cardiac silhouette Biventricular volume, Wall motion abnormality, Myocardial perfusion, Hypertrophic cardiomyopathy Mid-wall fibrosis in MRI Ejection fraction ≤35%, Pulmonary embolism, Right ventricular dilation or pericardial effusion with tamponade in echocardiography -
Malignant hypertension[9][10] +/- - + - - +/- - +/- +/- Microangiopathic hemolytic anemia ↑BUN, ↑Cr ↑Na, ↑K, ↑P Proteinuria, Microscopic hematuria Acidosis Cardiac enzymes, Urinary catecholamines, TSH, ↑Renin Not applicable Cardiomegaly, Pulmonary edema, Rib notching, Aortic coarctation, Mediastinal widening, Aortic dissection Not applicable Not applicable Left atrial enlargement and left ventricular hypertrophy in echocardiography -
Myocarditis[11] +/- - - - +/- - - +/- - Leukocytosis (eosinophilia),↑ESR and CRP Not applicable Not applicable Not applicable Not applicable Cardiac enzymes, Viral antibodies Not applicable Not applicable Not applicable Inflammatory edema, Degree of scarring Endomyocardial biopsy, Echocardiography, Scintigraphy Not applicable
Polycythemia[12][13] +/- - - - - - - +/- - ↑RBC, ↑HCT, ↑HGB, Thrombocytosis, Leukocytosis, ↑PT and aPTT ↓Erythropoietin Not applicable Not applicable Not applicable Hyperuricemia Splenomegaly Not applicable Not applicable Not applicable - Phlebotomy is the usual treatment
Respiratory distress syndrome[14] + - +/- - - - - + - Not applicable Not applicable Not applicable Not applicable Metabolic and respiratory acidosis Pulse oximetry Not applicable Bilateral, diffuse, reticular granular or ground-glass appearance +/- Cardiomegaly Not applicable Not applicable Patent ductus arteriosus in echocardiography -
Shock[15] +/- +/- +/- +/- +/- +/- - +/- - ↑HCT, ↑PT and aPTT, Eosinophilia, Leukocytosis ↓GFR, ↑BUN, ↑Cr Not applicable Not applicable ↑Lactate LFT, ↑BNP, ↑Troponin, D-dimer, Fibrinogen Pulmonary embolism, Pericardial effusion, Cardiac tamponade, Pneumothorax, Thoracic or abdominal aortic aneurysm in RUSH (Rapid Ultrasound for Shock and Hypotension) Pneumonia, Pneumothorax, Pulmonary edema, Widened mediastinum, Free air under the diaphragm Traumatic brain injury, Stroke, Spinal injury, Pneumonia, Pneumothorax, Ruptured aneurysm, Aortic dissection, Pulmonary embolism Not applicable - -
Renal causes Acute interstitial nephritis[16][17] +/- - +/- - +/- +/- +/- +/- +/- Eosinophilia ↑BUN, ↑Cr, ↑FENa Not applicable Eosinophiluria, Sterile pyuria, Microscopic hematuria, Proteinuria Not applicable ↑Total IgG, ↑IgG4 Normal-sized kidneys Not applicable Not applicable Not applicable - History of long term analgesic use
Goodpasture syndrome[18][19][20] +/- - - - - - - +/- +/- Anemia, Leukocytosis, ↑ESR ↑BUN, ↑Cr Not applicable Low-grade proteinuria, Gross or microscopic hematuria, RBC casts Not applicable Anti– glomerular basement membrane antibody Antineutrophilic cytoplasmic antibody Not applicable Bilateral, basal, patchy parenchymal consolidations Not applicable Not applicable Diffuse alveolar hemorrhage in pulmonary biopsy -

References

  1. ↑ Marr KA, Carter RA, Crippa F, Wald A, Corey L (April 2002). "Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients". Clin. Infect. Dis. 34 (7): 909–17. doi:10.1086/339202. PMID 11880955.
  2. ↑ Cornillet A, Camus C, Nimubona S, Gandemer V, Tattevin P, Belleguic C, Chevrier S, Meunier C, Lebert C, Aupée M, Caulet-Maugendre S, Faucheux M, Lelong B, Leray E, Guiguen C, Gangneux JP (September 2006). "Comparison of epidemiological, clinical, and biological features of invasive aspergillosis in neutropenic and nonneutropenic patients: a 6-year survey". Clin. Infect. Dis. 43 (5): 577–84. doi:10.1086/505870. PMID 16886149.
  3. ↑ Toto RD, Mitchell HC, Lee HC, Milam C, Pettinger WA (October 1991). "Reversible renal insufficiency due to angiotensin converting enzyme inhibitors in hypertensive nephrosclerosis". Ann. Intern. Med. 115 (7): 513–9. PMID 1883120.
  4. ↑ Bismuth C, Gaultier M, Conso F, Efthymiou ML (1973). "Hyperkalemia in acute digitalis poisoning: prognostic significance and therapeutic implications". Clin. Toxicol. 6 (2): 153–62. doi:10.3109/15563657308990513. PMID 4715199.
  5. ↑ LaCroix AZ, Lang J, Scherr P, Wallace RB, Cornoni-Huntley J, Berkman L, Curb JD, Evans D, Hennekens CH (June 1991). "Smoking and mortality among older men and women in three communities". N. Engl. J. Med. 324 (23): 1619–25. doi:10.1056/NEJM199106063242303. PMID 2030718.
  6. ↑ Mahle WT, Newburger JW, Matherne GP, Smith FC, Hoke TR, Koppel R, Gidding SS, Beekman RH, Grosse SD (August 2009). "Role of pulse oximetry in examining newborns for congenital heart disease: a scientific statement from the AHA and AAP". Pediatrics. 124 (2): 823–36. doi:10.1542/peds.2009-1397. PMID 19581259.
  7. ↑ Maron BJ, Towbin JA, Thiene G, Antzelevitch C, Corrado D, Arnett D, Moss AJ, Seidman CE, Young JB (April 2006). "Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention". Circulation. 113 (14): 1807–16. doi:10.1161/CIRCULATIONAHA.106.174287. PMID 16567565.
  8. ↑ Corrado D, Pelliccia A, Bjørnstad HH, Vanhees L, Biffi A, Borjesson M, Panhuyzen-Goedkoop N, Deligiannis A, Solberg E, Dugmore D, Mellwig KP, Assanelli D, Delise P, van-Buuren F, Anastasakis A, Heidbuchel H, Hoffmann E, Fagard R, Priori SG, Basso C, Arbustini E, Blomstrom-Lundqvist C, McKenna WJ, Thiene G (March 2005). "Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology". Eur. Heart J. 26 (5): 516–24. doi:10.1093/eurheartj/ehi108. PMID 15689345.
  9. ↑ Johnson W, Nguyen ML, Patel R (November 2012). "Hypertension crisis in the emergency department". Cardiol Clin. 30 (4): 533–43. doi:10.1016/j.ccl.2012.07.011. PMID 23102030.
  10. ↑ Elliott WJ (2006). "Clinical features in the management of selected hypertensive emergencies". Prog Cardiovasc Dis. 48 (5): 316–25. doi:10.1016/j.pcad.2006.02.004. PMID 16627047.
  11. ↑ Dec GW, Palacios IF, Fallon JT, Aretz HT, Mills J, Lee DC, Johnson RA (April 1985). "Active myocarditis in the spectrum of acute dilated cardiomyopathies. Clinical features, histologic correlates, and clinical outcome". N. Engl. J. Med. 312 (14): 885–90. doi:10.1056/NEJM198504043121404. PMID 3974674.
  12. ↑ Gregg XT, Prchal JT (January 1997). "Erythropoietin receptor mutations and human disease". Semin. Hematol. 34 (1): 70–6. PMID 9025165.
  13. ↑ Kralovics R, Indrak K, Stopka T, Berman BW, Prchal JF, Prchal JT (September 1997). "Two new EPO receptor mutations: truncated EPO receptors are most frequently associated with primary familial and congenital polycythemias". Blood. 90 (5): 2057–61. PMID 9292543.
  14. ↑ Hooper SB, Te Pas AB, Kitchen MJ (May 2016). "Respiratory transition in the newborn: a three-phase process". Arch. Dis. Child. Fetal Neonatal Ed. 101 (3): F266–71. doi:10.1136/archdischild-2013-305704. PMID 26542877.
  15. ↑ Vincent JL, De Backer D (October 2013). "Circulatory shock". N. Engl. J. Med. 369 (18): 1726–34. doi:10.1056/NEJMra1208943. PMID 24171518.
  16. ↑ Schwarz A, Krause PH, Kunzendorf U, Keller F, Distler A (September 2000). "The outcome of acute interstitial nephritis: risk factors for the transition from acute to chronic interstitial nephritis". Clin. Nephrol. 54 (3): 179–90. PMID 11020015.
  17. ↑ Praga M, González E (June 2010). "Acute interstitial nephritis". Kidney Int. 77 (11): 956–61. doi:10.1038/ki.2010.89. PMID 20336051.
  18. ↑ Pusey CD (October 2003). "Anti-glomerular basement membrane disease". Kidney Int. 64 (4): 1535–50. doi:10.1046/j.1523-1755.2003.00241.x. PMID 12969182.
  19. ↑ Bolton WK (November 1996). "Goodpasture's syndrome". Kidney Int. 50 (5): 1753–66. PMID 8914046.
  20. ↑ Kalluri R, Wilson CB, Weber M, Gunwar S, Chonko AM, Neilson EG, Hudson BG (October 1995). "Identification of the alpha 3 chain of type IV collagen as the common autoantigen in antibasement membrane disease and Goodpasture syndrome". J. Am. Soc. Nephrol. 6 (4): 1178–85. PMID 8589284.
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