Anuria - Urine, I cant piss Doctor

Dear patients

Thank you for your most interesting questions and thank you for trusting me to manage you health.

Anuria denotes absent urine production. Oliguria (<400mL urine/24h) is
more common than anuria. A catheter must be passed to confirm an
empty bladder.

Causes

• Urinary retention—prostatic hypertrophy, pelvic mass, drugs, e.g. tricyclic
• antidepressants, spinal cord lesions.
• Blocked indwelling urinary catheter.
• Obstruction of the ureters—tumour, stone, sloughed papillae (bilateral).
• Intrinsic renal failure—acute glomerulonephritis, acute interstitial nephritis, acute tubular necrosis, rhabdomyolysis.
• Pre-renal failure—dehydration, septic shock, cardiogenic shock.

An urgent ultrasound of the renal tract must be performed and any physical obstruction relieved as quickly as possible, directly (urethral catheter) or indirectly (nephrostomy).

Renal function and serum electrolytes must be measured without delay.

Further tests as clinically indicated

•  FBC.
•  Blood cultures.
•  Arterial blood gases (ABGS).
•  Uric acid.
•  Autoimmune profile.
•  ESR.
•  CK.
•  PSA (prostatic carcinoma).
•  Serum Ca2+ & PO4
•  12-lead ECG.
•  CXR.
•  CVP measurement via central line (to guide IV fluids).
•  MSU (UTI).
•  Urine microscopy (for casts).
•  Urine osmolality, sodium, creatinine, urea concentrations.
•  IVU (􀀉p516).
•  Urinary stone analysis, if available.
•  CT pelvis.
•  Renal biopsy (if intrinsic renal disease suspected, normal-sized kidneys).