Department of Intensive Care Unit (ICU), The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, 550004, People's Republic of China.
Department of Intensive Care Unit (ICU), Peking Union Medical College Hospital, Beijing, 100005, People's Republic of China.
J Anesth. 2024 Oct;38(5):681-691. doi: 10.1007/s00540-024-03342-4. Epub 2024 May 22.
Oliguria is a clinical symptom characterized by decreased urine output, which can occur at any stage of acute kidney injury and also during renal replacement therapy. In some cases, oliguria may resolve with adjustment of blood purification dose or fluid management, while in others, it may suggest a need for further evaluation and intervention. It is important to determine the underlying cause of oliguria during renal replacement therapy and to develop an appropriate treatment plan. This review looks into the mechanisms of urine production to investigate the mechanism of oliguria during renal replacement therapy from two aspects: diminished glomerular filtration rate and tubular abnormalities. The above conditions all implying a renal oxygen supply-demand imbalance, which is the signal of worsening kidney injury. It also proposes a viable clinical pathway for the treatment and management of patients with acute kidney injury receiving renal replacement therapy.
少尿是一种以尿量减少为特征的临床症状,可发生于急性肾损伤的任何阶段,也可发生于肾脏替代治疗期间。在某些情况下,调整血液净化剂量或液体管理可能会使少尿得到缓解,而在其他情况下,可能需要进一步评估和干预。在肾脏替代治疗期间,确定少尿的根本原因并制定适当的治疗计划非常重要。本综述探讨了尿液生成的机制,从肾小球滤过率降低和肾小管异常两个方面研究了肾脏替代治疗期间少尿的发生机制。上述情况均表明存在肾供需氧失衡,这是肾损伤加重的信号。它还为接受肾脏替代治疗的急性肾损伤患者的治疗和管理提出了一个可行的临床途径。