Oliguria differential diagnosis: Difference between revisions

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|[[End stage renal disease]]
|[[End stage renal disease]]<ref name="pmid20054047">{{cite journal |vauthors=Abboud H, Henrich WL |title=Clinical practice. Stage IV chronic kidney disease |journal=N. Engl. J. Med. |volume=362 |issue=1 |pages=56–65 |date=January 2010 |pmid=20054047 |doi=10.1056/NEJMcp0906797 |url=}}</ref><ref name="pmid28614683">{{cite journal |vauthors=Denic A, Mathew J, Lerman LO, Lieske JC, Larson JJ, Alexander MP, Poggio E, Glassock RJ, Rule AD |title=Single-Nephron Glomerular Filtration Rate in Healthy Adults |journal=N. Engl. J. Med. |volume=376 |issue=24 |pages=2349–2357 |date=June 2017 |pmid=28614683 |pmc=5664219 |doi=10.1056/NEJMoa1614329 |url=}}</ref><ref name="pmid15738453">{{cite journal |vauthors=Sarnak MJ, Greene T, Wang X, Beck G, Kusek JW, Collins AJ, Levey AS |title=The effect of a lower target blood pressure on the progression of kidney disease: long-term follow-up of the modification of diet in renal disease study |journal=Ann. Intern. Med. |volume=142 |issue=5 |pages=342–51 |date=March 2005 |pmid=15738453 |doi= |url=}}</ref><ref name="pmid16408129">{{cite journal |vauthors=Eriksen BO, Ingebretsen OC |title=The progression of chronic kidney disease: a 10-year population-based study of the effects of gender and age |journal=Kidney Int. |volume=69 |issue=2 |pages=375–82 |date=January 2006 |pmid=16408129 |doi=10.1038/sj.ki.5000058 |url=}}</ref><ref name="pmid16790511">{{cite journal |vauthors=Hallan SI, Coresh J, Astor BC, Asberg A, Powe NR, Romundstad S, Hallan HA, Lydersen S, Holmen J |title=International comparison of the relationship of chronic kidney disease prevalence and ESRD risk |journal=J. Am. Soc. Nephrol. |volume=17 |issue=8 |pages=2275–84 |date=August 2006 |pmid=16790511 |doi=10.1681/ASN.2005121273 |url=}}</ref><ref name="pmid15262664">{{cite journal |vauthors=Hsu CY, Vittinghoff E, Lin F, Shlipak MG |title=The incidence of end-stage renal disease is increasing faster than the prevalence of chronic renal insufficiency |journal=Ann. Intern. Med. |volume=141 |issue=2 |pages=95–101 |date=July 2004 |pmid=15262664 |doi= |url=}}</ref>
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|Endogenous toxins  
|Endogenous toxins<ref name="pmid20533382">{{cite journal |vauthors=Borowitz MJ, Craig FE, Digiuseppe JA, Illingworth AJ, Rosse W, Sutherland DR, Wittwer CT, Richards SJ |title=Guidelines for the diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria and related disorders by flow cytometry |journal=Cytometry B Clin Cytom |volume=78 |issue=4 |pages=211–30 |date=July 2010 |pmid=20533382 |doi=10.1002/cyto.b.20525 |url=}}</ref><ref name="pmid6282181">{{cite journal |vauthors=Knochel JP |title=Rhabdomyolysis and myoglobinuria |journal=Annu. Rev. Med. |volume=33 |issue= |pages=435–43 |date=1982 |pmid=6282181 |doi=10.1146/annurev.me.33.020182.002251 |url=}}</ref><ref name="pmid17338959">{{cite journal |vauthors=Giannoglou GD, Chatzizisis YS, Misirli G |title=The syndrome of rhabdomyolysis: Pathophysiology and diagnosis |journal=Eur. J. Intern. Med. |volume=18 |issue=2 |pages=90–100 |date=March 2007 |pmid=17338959 |doi=10.1016/j.ejim.2006.09.020 |url=}}</ref><ref name="pmid6645213">{{cite journal |vauthors=Coe FL |title=Uric acid and calcium oxalate nephrolithiasis |journal=Kidney Int. |volume=24 |issue=3 |pages=392–403 |date=September 1983 |pmid=6645213 |doi= |url=}}</ref><ref name="pmid15202612">{{cite journal |vauthors=Maalouf NM, Cameron MA, Moe OW, Sakhaee K |title=Novel insights into the pathogenesis of uric acid nephrolithiasis |journal=Curr. Opin. Nephrol. Hypertens. |volume=13 |issue=2 |pages=181–9 |date=March 2004 |pmid=15202612 |doi= |url=}}</ref>
- [[Hemoglobin]]
- [[Hemoglobin]]



Revision as of 17:28, 22 April 2018

Oliguria Microchapters

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


An expert algorithm to assist in the diagnosis of oliguria can be found here

Overview

There are several life-threatening causes of oliguria which need to be evaluated for first, which include; sepsis, urethral stricture, dehydration and shock . The other possible causes of oliguria can be evaluated by carefully assessing the nature of the symptoms, and obtaining a thorough patient history.

Differential Diagnosis

Life Threatening Causes

Life threatening diseases to exclude immediately include:[1][2]

Common Causes

Differential Diagnosis of Oliguria

The following table outlines the major differential diagnoses of Oliguria.

Abbreviations: ABG = Arterial blood gases, CBC = Complete blood count, KFT = Kidney function test, MRI = Magnetic resonance imaging, CT = Computed tomography,

Classification by etiology 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 Haematuria/Proteinuria Edema CBC KFT Electrolytes Urine analysis ABG Ultrasound X-ray CT MRI
Prerenal Alcohol poisoning[3][4][5][6]
Aspergillosis[7][8][9]
Cholera[10][11][11][12]
Congestive heart failure[13][14][15][16][17][18]
Dehydration[19][20][21][22]

- Burns

-Cutaneous loss e.g. sweating

- Inadequate water intake

- Salt-wasting nephropathy

Diabetes insipidus[23][24][25][26]
Diabetes mellitus[27][28][29]
Diarrhea and/or vomiting[30][31][32][33]
Drugs/toxins[34][35][36][37]

- ACE inhibitor

- Aminoglycosides

- Amphotericin B

- Contrast material

- Cyclosporin

- Diuretics

- Digitalis

- Heavy metals

- Indomethacin

- Tacrolimus

- NSAIDs

Esophageal varices bleeding[38][39]
Heart disease[40][41][42]

-Congenital

-Acquired

Hemorrhage[43][44][45][46]
Hemolysis[47][48][49][50]
Hepatorenal syndrome[51][52][53][54]
Ischemic cardiomyopathy[55][56][57][58]
Liver cirrhosis[59][60][61]
Malignant hypertension[62][63]
Myocarditis[64][65][66][67]
Peritonitis[68][69]
Perinatal asphyxia[70][71][72]
Polycythemia[73][74][75][76][77]
Respiratory distress syndrome[78][79][80][81]
Shock[82][83][84][85]

- Anaphylactic

- Cardiogenic

- Hypotensive

- Septic

- Toxic

Third space losses[86][87][88]

- Capillary leak

- Surgery

- Trauma

Toxic megacolon[89][90][91][92]
Intrinsic renal Acute interstitial nephritis[93][94][95][96]
Acute tubular necrosis[97][98][99][100][101]
Cancer[102][103][104][105][106]

- Renal cell carcinoma

- Metastatic cancer

Chronic kidney failure[107][108][109][110][111][112]
Congenital kidney disease[113][114][115][116][117]

- Agenesis

- Dysplasia

- Hypoplasia

- Polycystic

End stage renal disease[107][108][109][110][111][112]
Endogenous toxins[118][119][120][121][122]

- Hemoglobin

- Myoglobin

- Uric acid

Glomerulonephritis
Goodpasture syndrome
Hemolytic uremic syndrome
Nephrolithiasis
Nephrotic syndrome
Thrombosis

- Renal vein

- Renal artery

Transplant rejection
Transient dysfunction of the newborn[78][79][80][81]
Postrenal Bladder outlet obstruction
Benign prostatic hyperplasia
Catheter-related
Chronic prostatitis
Obstructive uropathy
Neurogenic bladder

References

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