Dawaa Reference

chronic

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.