Acute renal failure (ARF) occurs in ∼5% of hospitalized patients. Oliguria is defined as urine output less than 400cc over 24h. The functional derangement associated with acute oliguria is a sudden decrease in the glomerular filtration rate (GFR), leading to increased serum urea and creatinine, sodium and water retention, hyperkalemia, and acidosis. The initial approach toward oliguria is to verify its presence by checking the most recently recorded urine outputs. Oliguria and impending ARF have ∼50% mortality rate in surgical patients most commonly from sepsis and multiorgan failure. Oliguria is classified into prerenal, intrinsic, and postrenal causes. Prerenal and postrenal etiologies must be excluded first because they are often reversible if treated in a timely manner. Initial management entails a detailed history, physical exam, and blood and urine studies, which should be sent prior to instituting therapy.
KeywordsGlomerular Filtration Rate Acute Renal Failure Pulmonary Capillary Wedge Pressure Acute Tubular Necrosis Urethral Stricture
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