Do not Attempt to Convert Oliguric to Nonoliguric Renal Failure with Diuretics
Brandon R. Bruns MD
Heidi L. Frankel MD
Oliguria, recently defined as urine output of less than 0.3 mL/kg/h for a 24-hour period, is a common problem in the intensive care unit (ICU). Oliguria is an important harbinger of acute renal failure. Nearly 70% of ICU patients who develop acute renal failure are oliguric. Classically, renal failure has been ascribed to three causes: prerenal, renal, and postrenal.
Prerenal
Absolute decrease in intravascular volume
Hemorrhage
Fluid sequestration (e.g., pancreatitis, after an exploratory laparotomy, burns, diarrhea, and vomiting)
Renal perfusion impairment
Thrombosis of renal vasculature
Emboli to the renal artery
Abdominal compartment syndrome
Dissection of a renal artery
Relative decrease in intravascular volume
Vasodilatation associated with sepsis
Severe right-sided heart failure
Cirrhosis
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