# Anuria or oliguria - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care ## Treatment metadata - No drug therapy in primary care (Referral & Advice) ## Complete treatment card ```text ANURIA OR OLIGURIA 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/ Review status: REVIEWED against the source listed above (2026-08) 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 Source StatPearls "Oliguria" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE) [1st line] Adult 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 Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. 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. Caution 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. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)