Oliguria with fatigue, vomiting, and diarrhea

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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 Alcohol poisoning[1][2] + - +/- - +/- + +/- - - PT BUN, ↑Cr (isopropyl alcohol) Na Not applicable HCO3 LFT Not applicable Not applicable Not applicable Not applicable - Thiamine must be given to prevent Wernicke's encephalopathy
Cholera[3][4][4][5] +/- + - - - +/- + - - Leukocytosis, ↑HCT BUN, ↑Cr Na, ↑Ca, ↑Mg Not applicable Lactate, ↓HCO3 Stool PCR, Stool culture, Serotyping Not applicable Not applicable Not applicable Not applicable - -
Dehydration[6][7] + + - +/- - +/- +/- - - Not applicable BUN, ↑Cr Na, ↑K, ↓Cl Ketones and glucose, ↑Urine specific gravity Lactate, ↓HCO3 Hypoglycemia Not applicable Not applicable Not applicable Not applicable - -
Diarrhea and/or vomiting[8][9] +/- +/- - - - + + - - Leukocytosis with predominant neutrophilia, ↑ ESR Not applicable Not applicable Ketones, Organic acids, Porphobilinogen, Aminolevulinic acid Not applicable Stool anion gap, Stool pH < 5.5, Stool culture, Serotyping, Enzyme immunoassay (rotavirus or adenovirus), LFT, Amylase, Lipase Normal Not applicable Not applicable Not applicable - -
Drugs/toxins[10][11] +/- +/- +/- +/- +/- +/- +/- +/- +/- 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 - -
Toxic megacolon[12] +/- +/- +/- - + + +/- - - Leukocytosis, Anemia, ↑ESR and CRP BUN, ↑Cr Na Not applicable Not applicable Loss of haustra, Hypoechoic and thick bowel walls, Dilated colon > 6cm, Dilatation of ileal loops Dilated colon, Free intraperitoneal air Bowel perforation, Abscess Not applicable Not applicable Endoscopy and colonoscopy -
Renal causes Acute interstitial nephritis[13][14] +/- - +/- - +/- +/- +/- +/- +/- 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
Hemolytic uremic syndrome[15][16][17] +/- - +/- +/- +/- + + - +/- Severe anemia, Thrombocytopenia, ↑ aPTT BUN, ↑Cr Not applicable Mild proteinuria, Red blood cells, Red blood cell casts Not applicable Schistocytes, ↑FDP and D-dimer, ↑ Bilirubin, ↑LDH, ↓Haptoglobin, Stool culture (for E coli 0157:H7 or shigella), ↓ADAMTS-13 activity Ruling out obstruction Not applicable Not applicable Not applicable Diffuse thickening of the glomerular capillary wall, Swelling of endothelial cells, Fibrin thrombi in renal biopsy -

References

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