Urine output - decreased

Alternative names
Oliguria

Definition
Decreased urine output is defined as producing less than 500 ml of urine in 24 hours.

Considerations
Though a significant decrease in urine output may indicate a serious, even life-threatening condition, adequate urine output can be restored with prompt medical treatment.

Common Causes

     
  • Dehydration due to vomiting, diarrhea or fever, and a simultaneous lack of adequate fluid intake  
  • Total urinary tract obstruction, such as may result from an enlarged prostate  
  • Severe infection leading to shock  
  • Drugs such as anticholinergics, methotrexate, and diuretics

Home Care
Follow prescribed fluid regimens and measure urine output as directed.

Call your health care provider if

     
  • There is any noticeable and consistent decrease in urine output.  
  • You have been vomiting or having bouts of diarrhea or high fever and are unable to take in enough replacement fluid by mouth.  
  • The decrease in urine output is associated with dizziness, lightheadedness, or rapid pulse.

What to expect at your health care provider’s office
The medical history will be obtained, and a physical examination performed.

Medical history questions documenting decreased urine output in detail may include:

     
  • Time pattern       o When did this begin?       o Did it occur suddenly?       o Has it rapidly become worse?  
  • Quality       o How much fluid is consumed each day?       o How much urine is produced each day?       o What color is the urine?  
  • Aggravating factors       o Has there been fever?       o Has there been diarrhea?       o Has there been vomiting? With or without nausea?       o Is thirst decreased?  
  • Other       o Does increasing fluid intake increase urine output?       o What other symptoms are also present?       o Is there puffiness in the skin, around the eyes, or in the hands or feet?       o Is there moist, pink, warm skin?       o Is there loose, dry, pale skin?       o Are the lips and mouth dry?       o Is there a distended bladder (can you feel a firm bulge in the pelvis over the pubic bone)?       o What medications are being taken?       o Are there any allergies?       o Are adequate fluids available and accessible?  
  • Past history       o Have there been any recent injuries such as burns?       o Have there been any recent illnesses?       o Have there been previous problems with the kidneys or bladder?

A physical examination will be performed. A catheter may be placed in the urinary bladder to relieve an obstruction and to assist with careful measurement of urine output. Some patients need to be hospitalized for fluid management.

Diagnostic tests that may be performed include:

     
  • Blood studies to monitor electrolytes and renal function  
  • CT (cat) scan of the abdomen  
  • Intravenous pyelogram (IVP)  
  • Renal scan  
  • Abdominal ultrasound  
  • Urine tests, including tests for infection

After seeing your health care provider:
You may want to add a diagnosis related to decreased urine output to your personal medical record.

Johns Hopkins patient information

Last revised: December 6, 2012
by Dave R. Roger, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.