Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android. Learn more here!



General Considerations

It is helpful to categorize the mechanism of oliguria or anuria as prerenal (eg, resulting from decreased or abnormal renal perfusion), renal (eg, resulting from intrinsic renal disease), or postrenal (eg, disease of the urinary collecting system distal to the renal parenchyma). Prerenal and postrenal causes are often elicited by the history and physical examination. It is helpful to determine the presence and severity of acute kidney injury (AKI) that frequently accompanies oliguria and anuria.

A. Prerenal Causes

Prerenal causes include hypovolemia, sepsis, and heart failure.

B. Renal Causes

Renal causes include tubular, glomerular, vascular, or interstitial renal disease.

C. Postrenal Causes
1. Supravesical obstruction

Supravesical obstruction, which is above the bladder, rarely causes oliguria or anuria, because bilateral disease is required to reduce decreased urine flow. There are two types of supravesical obstruction: (1) ureteral obstruction (usually tumor) and (2) ureteropelvic or ureterovesical obstruction.

2. Intravesical or infravesical obstruction

Intravesical or infravesical obstruction is more common than supravesical obstruction in the etiology of oliguria or anuria. See Table 39–1 for causes.

Table 39–1.Diagnostic clues to the cause of bladder outlet obstruction.

Clinical Findings

A. History
1. Obstruction

One must differentiate between reduced urine output with normal or near-normal voiding patterns, and oliguria associated with difficulty in voiding, which can include the feeling of urgency, suprapubic fullness and diminished urinary stream. The latter findings suggest obstruction.

2 Associated medical conditions

Ask about coexisting ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.