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By Medicover Hospitals / 07 March 2022
What is Low Urine Output? Causes Diagnosis Treatment When to visit a Doctor? Prevention Frequently Asked Questions

Your kidneys produce more or less urine, depending on what your body needs to maintain balance. If you urinate too much or not enough, it can sometimes be a sign that something is wrong. Low urine output is a symptom commonly experienced by people who are sick and have lost too many fluids. It also occurs in people who have a urinary tract obstruction. However, the body can produce less urine for several reasons, which will require different treatments.

What is Low Urine Output?

Low urine output in medical terms is Oliguria. Oliguria is known to be less than 400 milliliters of urine output, which is less than approximately 13.5 ounces over 24 hours. Anuria is a disorder where urine does not exist. Anuria is known to be less than 50 milliliters, or less than around 1.7 ounces of urine, over 24 hours. Low urine output, or no urine output, occurs in the setting of Kidney failure and urinary obstruction. As the kidneys fail or are compromised in their ability to function, the kidneys lose the ability to regulate fluids and electrolytes and to remove waste products from the body. Also, it decreases the production of red blood cells (which is normally driven by a substance produced in the kidneys). Low urine output also occurs when there is a decreased blood supply to the kidney, as occurs with dehydration or excessive blood loss. Obstruction of the outflow of urine, whether because of tumors, an enlarged prostate, or bladder problems, can also reduce urine output. Kidney failure can cause decreased urine production that is either acute (as with toxins or sepsis) or chronic (as with diabetes). Chronic kidney failure develops over time and can be the result of poorly controlled diabetes or hypertension.

Causes

Dehydration

The most prevalent cause of reduced urine production is dehydration. Dehydration usually occurs when you are sick with diarrhea, vomiting, or another illness and cannot replace the fluids you are losing. When this happens, the kidneys retain as much fluid as possible.

Infection or trauma

Oliguria may also be caused by illness or trauma. These can make the body go into shock. This lowers the supply of blood to your organs. Shock is a medical emergency that needs to be treated right away.

Urinary tract obstruction

An obstruction or blockage of the urinary tract occurs when urine cannot leave the kidneys. This can affect one or both kidneys and results in decreased urine output. Depending on how quickly the blockage occurs, a blockage can also cause other symptoms, such as:

Medications

Some medicines can make you make less urine. Medications are known to cause this include:

  • 1. Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • 2. ACE antagonists, for example, are blood pressure drugs
  • 3. Gentamicin, an antibiotic
  • 4. If your medicine causes you to release less urine, discuss your concerns with your doctor. They can change your medication or adjust your current dose

    • Diagnosis

    When a doctor asks about your symptoms, they will suggest you take the following test according to your symptoms:Your doctor will start by asking questions about how long you've had the problem, how bad it is, and other things that might happen to you. Your doctor will probably do a physical exam and want a sample of your urine for testing.

    Other tests:

    Doctors may also want to do more tests to determine what caused the decrease in urine output and whether the decrease has caused kidney damage. Some tests run include:

    Urinalysis

    A complete blood count test helps in showing what is causing diarrhea. To detect an infection, including urinalysis and urine culture. Additional kidney function tests include 24-hour urine tests in which urine is collected and analyzed for one day at home.

    Ultrasound or computed tomography of the abdomen

    To check for obstruction, such as a dilated kidney (hydronephrosis).

    Blood test

    To check your electrolytes, blood count, or kidney function.

    Cystoscopy

    A procedure performed by a urologist involves the use of a small camera to view the inside of the bladder.

    Treatment

    The treatment of oliguria depends on the cause. If you are dehydrated, your doctor will recommend that you drink more fluids and electrolytes. In severe cases, you may need fluids through an IV (a tube that puts fluid directly into a vein in your hand or arm). More fluids can also help you clear small kidney stones, as can medications that relax the muscles in the tube that carries urine from the kidneys to the bladder (ureter). If the stones are large, your doctor may recommend using sound waves to break them up or surgery to remove them. Surgery can also repair other types of blockages. If the oliguria is caused by kidney disease, you will see a specialist (called a nephrologist) who will work with you to control the condition or slow it down. In severe cases, you may need a transplant or dialysis, a process that removes excess water and toxins from your blood, since your kidneys cannot.

    When to visit a Doctor?

    • There is no noticeable and steady decrease in urine output.
    • You have been vomiting or have had bouts of diarrhea or high fever and cannot drink enough fluids to replace what you have lost.
    • Decreased urine output is associated with dizziness, lightheadedness, or a rapid pulse.

    Prevention

    Taking more water intake helps to prevent the low urine output. If you don't want to drink only water then replace water with coconut water, any fruits or fruit juices that have more water content.

    Citations

    https://www.nejm.org/doi/full/10.1056/NEJM199803053381007
    https://www.liebertpub.com/doi/abs/10.1089/end.1994.8.349
    https://www.sciencedirect.com/science/article/abs/pii/0090429594902305

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    Frequently Asked Questions

    1. What if my urine output is low?

    Low urine output is a symptom commonly experienced by people who are sick and have lost too many fluids. It also occurs in people who have a urinary tract obstruction.

    2. What is low urine output a sign of?

    Common causes include dehydration from not drinking enough fluids and vomiting, diarrhea, or fever. Total blockage of the urinary tract, as from an enlarged prostate.

    3. How is low urine output treated?

    An easy way to treat oliguria is by increasing the number of fluids you drink. This can often be done at home by drinking more water or rehydration solutions that include electrolytes.

    4. How long can you go without urinating?

    It takes your body 9 to 10 hours to produce 2 cups of urine. That's as long as you can wait and still be in the safe zone without the possibility of damaging your organs.

    5. What is low urine output per hour?

    Urine output of less than 30 ml/hr (approximately 0.5 ml/kg/hour for a 70-kilogram patient) should be considered a cause for concern.