1
Q
Oliguria
A
2 hours
2
Q
Prerenal causes of oliguria
A
Decreased CO (e.g. volume depletion, HF, tamponade) Redistribution of blood flow ( distributive shock) with peripheral vasodilation and/or shunting
3
Q
Renal causes of oliguria
A
- Glomerular disease (glomerulonephritis)
- Vascular disease ( e.g. vasculitis)
- Interstitial disease (e.g. antibiotics)
- Renal tubular disease
- Ischemia
- Nephrotoxic drugs
4
Q
Postrenal (obstructive) causes of oliguria
A
- Bilateral ureteral obstruction
- Urethral stricture
- Bladder outlet obstruction
- Urinary catheter obstruction
5
Q
What does a BUN/Cr > 20 suggest?
A
Prerenal
6
Q
What is the expected BUN/Cr in ATN?
A
10-20
7
Q
What are the RIFLE criteria?
A
Risk:
Increased Cr x 1.5 or GFR decreased > 25%
UO 50%
UO 4 or acute rise of >0.5 mg/dL) or GFR decreases by >75%
UO
8
Q
If patient is oliguric after fluid challenge, what is the next step?
A
High dose loop (e.g. furosemide 200 mg slow IV push)
9
Q
If the patient is in oliguric renal failure, what is the fluid management?
A
Fluids should be restricted to the replacement of ongoing losses.
Shock
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