Oliguria in critically ill patients: a narrative review

J Nephrol. 2018 Dec;31(6):855-862. doi: 10.1007/s40620-018-0539-6. Epub 2018 Oct 8.

Abstract

Oliguria is often observed in critically ill patients. However, different thresholds in urine output (UO) have raised discussion as to the clinical importance of a transiently reduced UO of less than 0.5 ml/kg/h lasting for at least 6 h. While some studies have demonstrated that isolated oliguria without a concomitant increase in serum creatinine is associated with higher mortality rates, different underlying pathophysiological mechanisms suggest varied clinical importance of reduced UO, as some episodes of oliguria may be fully reversible. We aim to explore the clinical relevance of oliguria in critically ill patients and propose a clinical pathway for the diagnostic and therapeutic management of an oliguric, critically ill patient.

Keywords: Acute kidney injury; Biomarker; Oliguria; Renal replacement therapy.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / diagnosis*
  • Acute Kidney Injury / mortality
  • Acute Kidney Injury / physiopathology
  • Acute Kidney Injury / therapy
  • Biomarkers / blood
  • Creatinine / blood
  • Critical Illness
  • Fluid Shifts
  • Hemodynamics
  • Humans
  • Kidney / physiopathology*
  • Kidney Function Tests
  • Oliguria / diagnosis*
  • Oliguria / mortality
  • Oliguria / physiopathology
  • Oliguria / therapy
  • Predictive Value of Tests
  • Renal Replacement Therapy
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome
  • Urodynamics*
  • Water-Electrolyte Balance

Substances

  • Biomarkers
  • Creatinine