Dawaa Reference

Clinical reference

Anuria or oliguria

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class US05.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Oliguria(Archived) - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK560738/

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (1)

  • Urine output swinging between scanty and heavy suggests intermittent blockage of the tract

Signs — what you find (2)

  • A palpable, distended bladder signals acute retention [urinary retention]
  • Skin turgor and mucous membranes gauge hydration, which separates out pre-renal causes

Tests (11)

  • Baseline bloods: creatinine, urea, electrolytes and blood urea nitrogen
  • Collect the urine sample before any fluids or drugs are given
  • Bedside bladder ultrasound settles at once whether urine is being retained
  • Urine specific gravity above 1.02 fits pre-renal, below 1.01 fits renal
  • Urinary sodium under 20 mmol/L fits pre-renal, over 40 mmol/L fits renal disease
  • Fractional sodium excretion below 1% is pre-renal, above 1% is renal
  • Urine osmolality over 500 is pre-renal and under 350 renal; urine-to-plasma osmolarity over 1.5 versus under 1.1
  • A urea-to-creatinine ratio above 20:1 favours pre-renal, below 10:1 favours renal disease
  • Hyaline and fine granular casts point to a pre-renal cause; brown granular casts carrying tubular epithelial cells point to a renal one
  • Send an autoimmune screen in selected cases: ANA, ANCA and complement levels
  • A dilated tract may be absent despite obstruction, notably with malignancy, severe dehydration or early presentation

If not this — what else fits (5)

  • Pre-renal azotaemia
  • Acute glomerulonephritis
  • Oliguric acute tubular necrosis
  • Non-oliguric acute tubular necrosis
  • Urinary tract obstruction

SourceStatPearls "Oliguria" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

A serious sign of acute kidney injury or urinary obstruction; primary care recognises the emergency and refers immediately rather than treating with medication. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

A serious sign of acute kidney injury or urinary obstruction; primary care recognises the emergency and refers immediately rather than treating with medication.

Cautions
  • RED FLAG - Acute pulmonary edema / fluid overload due to anuria: assess urgently and refer.
  • RED FLAG - Severe hyperkalemia (muscle weakness, ECG changes like peaked T-waves): assess urgently and refer.
  • No urine output or markedly reduced urine output is a medical emergency requiring urgent hospital referral to identify and treat obstruction or acute kidney injury.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.