Anuria

Symptoms. Stop urination. After 1 - 3 day absence of urine the symptoms of kidney failure: dry mouth, thirst, nausea, vomiting, headache, itchy skin. In the body of nitrogenous waste products accumulate - protein decomposition products, as well as potassium, chloride, non-volatile organic acids. Acidosis occurs. Broken water and salt metabolism. The growth azotemicheskoy intoxication leads to the development of uremia, there is a weakness, drowsiness, vomiting, diarrhea, and sometimes swelling, shortness of breath, blackout, ammonia smell from the mouth. Urea and serum creatinine increases to 100-200 and 12-15 mg / dL, respectively, and sometimes higher (normal levels of urea in the blood serum of 15-35 mg / dl, creatinine - 1-1.5 mg / dL).

Diagnosis. Anuria primarily differentiated from acute urinary retention. In children, acute retention of urine sometimes occurs due to spasm of the sphincter of the bladder. In other cases, the child can freely hold urine because of pain of urination (with vulvovaginitis, balanoposthitis). The cause of urinary retention in children may also be phimosis, urethral trauma, central nervous system diseases, stones, suffered from the urethra. In adults, acute urinary retention may be adenoma and prostate cancer, fracture urethral obstruction urethral stones, acute prostatitis, paraproctitis, diseases of the central nervous system. To exclude acute urinary retention is necessary to make catheterization of the bladder. In anuria by a catheter inserted into the bladder, the urine does not stand out or you see a few drops of it.
It is important to determine the form of anuria (excretory or secretory), as it affects the nature of the therapeutic measures. The presence of calculous anuria origin according to data history (urolithiasis, stone passage, about the removal of the kidney stone disease), prior anuria renal colic. When tumors of the pelvic organs before the advent of anuria in patients can be a pain in the lumbar region. Secretory anuria not accompanied by such pain. In patients suffering from endocarditis, heart disease, hypertension, atherosclerosis, myocardial infarction, or with a history of stroke, the cause of anuria may be renal vein thrombosis.
Emergency. In patients with pre-renal form of secretory anuria emergency medical assistance should be directed to the maintenance of cardiovascular activity. With symptoms of circulatory collapse, collapse should be introduced subcutaneously 2.1 ml of a 10% solution of caffeine intravenously - 20 ml of 40% glucose solution and put the heating pad to the feet. In shock (see) must quickly to restore normal blood pressure. With a large blood loss requires immediate redress and its use of the devices sposobstvuyuschihsch stabilize vascular tone (central venous pressure), which is used intravenously poliglyukina 400-800 ml, 300-500 ml gemodeza (neokompensana).
Admissions to state of shock - in the intensive care unit.
When obstructive anuria main form of treatment - operational, so patients with this type of anuria shown urgent hospitalization or urological surgery, where it is possible to provide emergency assistance, including emergency cystoscopy, catheterization of the ureters, the x-rays and emergency surgical removal of the cause of the violation of the passage of urine the upper urinary tract (removal of the stone, drainage pelvic kidney, etc.).
When renal anuria caused by poisoning Renting, post-abortion sepsis, acute renal failure, require emergency hospitalization, which has a device for peritoneal dialysis or device <artificial kidney>. In anuria due to chronic kidney disease or severe heart failure hospitalization in emergency medical department.
Anuria - complete cessation of receipt of urine in the bladder. Must be distinguished from the anuria of acute urinary retention in which the bladder is full of urine, but urine is impossible because of the outflow obstruction of urine through the urethra. In anuria bladder is empty. Or urine excreted by the kidneys, or do not come into the bladder due to obstacles in the course of the upper urinary tract. Depending on the cause of the Lich arenalnuyu time, pre-renal, renal and subrenalnuyu and reflex anuria. Arenalnaya anuria is rare. It occurs in infants with congenital absence (aplasia of the kidneys). The absence of urine in infants in the first 24h of life - is normal and should not be fearsome. Prolonged absence of urination in the infant requires clarification reasons of urgency. Babies may be a delay of urine due to the presence of thin adhesions in tverstiya external urethral valves or congenital urethra.