Oligüriler - Anüriler
Özet
Oligüri ve anüri, günlük idrar miktarının kritik seviyelerin altına düşmesiyle karakterize edilen ve sıklıkla akut böbrek yetmezliğinin ilk belirtisi olarak ortaya çıkan ciddi klinik durumlardır. Bu durumlar etyolojik kökenlerine göre böbrek öncesi (prerenal), böbrek kaynaklı (renal) ve böbrek sonrası (postrenal) nedenler olarak sınıflandırılarak, detaylı fizik muayene ve laboratuvar testleri ile teşhis edilir. Tedavi süreci altta yatan temel faktörün düzeltilmesine, hemodinamik stabilizasyonun sağlanmasına ve böbrek perfüzyonunun artırılmasına odaklanarak hastanın yakından takibini gerektirir.
Oliguria and anuria are serious clinical conditions characterized by urine output falling below critical levels, often serving as the first indicator of acute kidney injury. These conditions are classified into prerenal, renal, and postrenal causes based on their etiology and are diagnosed through detailed physical examination and laboratory tests. The treatment process focuses on correcting the underlying cause, ensuring hemodynamic stabilization, and increasing renal perfusion while requiring close patient monitoring.
Referanslar
Klahr, S, and S B Miller. “Acute oliguria.” The New England journal of medicine vol. 338,10 (1998): 671-5. doi:10.1056/NEJM199803053381007
Rimmelé, Thomas, and John A. Kellum. "Oliguria and fluid overload." Fluid Overload 164 (2010): 39-45.
Yeniçerioğlu Y. Oligüri-Anüri: Temel Yaklaşım ve Tedavi Turkiye Klinikleri J Surg Med Sci. 2007;3( 20):9-15.
Cerda J. Oliguria: an earlier and accurate bio- marker of acute kidney injury? Kidney Inter- national. 2011;80(7):699-701.
Case J, Khan S, Khalid R, Khan A. Epidemi- ology of acute kidney injury in the intensive care unit. Crit Care Res Pract. 2013;2013:479730.
Nash, Kevin et al. “Hospital-acquired renal insufficiency.” American journal of kidney diseases : the official journal of the National Kidney Foundation vol. 39,5 (2002): 930-6. doi:10.1053/ajkd.2002.32766
Hoffman, Martin D., and Robert H. Weiss. "Does acute kidney injury from an ultramarathon increase the risk for greater subsequent injury?." Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine 26.5 (2016): 417.
Borde DJ, Samra GP. Oliguria and Anuria. In: Paulman PMP, Audrey AH, Jeffrey DN, Laeth- Jarzynka K, editors. Taylor's Differential Diag- nosis Manual: Symptoms and Signs in the Time-Limited Encounter. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2014. p. 216-41.
Irving, R. A., et al. "Transient oliguria with renal tubular dysfunction after a 90 km running race." Medicine and Science in Sports and Exercise 22.6 (1990): 756-761.
Bell, Samira, et al. "Management of post-operative acute kidney injury." QJM: An International Journal of Medicine 110.11 (2017): 695-700.
Hultström, Michael. "Neurohormonal interactions on the renal oxygen delivery and consumption in haemorrhagic shock‐induced acute kidney injury." Acta Physiologica 209.1 (2013): 11-25.
Ruiz‐del‐Arbol, Luis, et al. "Circulatory function and hepatorenal syndrome in cirrhosis." Hepatology 42.2 (2005): 439-447.
Fani, Filippo, et al. "Recent advances in the pathogenetic mechanisms of sepsis-associated acute kidney injury." Journal of nephrology 31.3 (2018): 351-359.
Verma, Sudhanshu Kumar, and Bruce A. Molitoris. "Renal endothelial injury and microvascular dysfunction in acute kidney injury." Seminars in nephrology. Vol. 35. No. 1. WB Saunders, 2015.
Tonbul HZ. Akut Böbrek Hasarının Tanımı ve Sınıflandırması. Türkiye Klinikleri J Nephrol- Special Topics 7(4):1-6
Joannidis, M., et al. "Prevention of acute kidney injury and protection of renal function in the intensive care unit: update 2017." Intensive care medicine 43.6 (2017): 730-749.
Chawla LS, Davison DL, Brasha-Mitchell E, Koyner JL, Arthur JM, Shaw AD, Tumlin JA, Trevino SA, Kimmel PL, Seneff MG. Development and standardization of a furosemide stress test to predict the severity of acute kidney injury. Crit Care. 2013;17(5):R207. doi: 10.1186/cc13015.
Legrand, Matthieu, et al. "Failure of renal biomarkers to predict worsening renal function in high-risk patients presenting with oliguria." Intensive care medicine41.1 (2015): 68-76.
Verhatarman R, Kellum JA. Treatment of acute oliguria. In: Newman MF, Fleisher LA, Fink MP, editors. Perioperative Medicine: Managing for Outcome: Saunders Elsevier; 2008. p. 261-6.
Subramanian S, Kellum JA, Ronco C. Olig- uria. In: Ronco C, Bellomo R, Kellum JA, edi- tors. Critical Care Nephrology: Elsevier Health Sciences; 2009. p. 341-4.
UppalapatiA,KellumJA.Oliguria,clinicalsig- nificance. Encyclopedia of Intensive Care Medicine: Springer; 2012. p. 1616-8.
Mokhmalji H, Braun PM, Martinez Portillo FJ et al. Percutaneous nephrostomy versus ureteral stents for diversion of hydronephrosis caused by stones: a prospective, randomi- zed clinical trial. J Urol 2001; 165: 1088–92.
Goldsmith ZG, Oredein-McCoy O, Gerber L, et al. Emer- gent ureteric stent vs percutaneous nephrostomy for obs- tructive urolithiasis with sepsis: patterns of use and outco- mes from a 15-year experience. BJU Int 2013;112:122-8.
