Non-Oliguric Renal Failure 尿路閉塞性腎障害の一病像

Abstract

Generally, oliguria or anuria is a characteristic feature in renal failure. It is less recognized, however, that renal failure may occur in the presence of a normal or increased urine output. This phenomenon has been called non-oliguric or high output renal failure. We have recently experienced nine such cases at the Fukuoka University Hospital since 1973. All of them accompanied with urinary tract obstruction. Six of them had ureteral obstruction. Daily urine output, serum creatinine and blood urea nitrogen were measured before and after relief of obstruction. In all of six cases, daily urine output was more than 600ml but azotemia and serum creatinine were progressively increasing. Moreover, GFR, serum osmolality, absolute osmolar clearance, fractional osmolar clearance (Cosm/GFR), sodium clearance and excretion fraction of filtered sodium (EFNa) were measured in three cases.We emphasize that most of postrenal renal failure following chronically progressive obstruction of urinary tract exhibits such characteristic features without oliguria, and that measurement of daily urine volume is not a reliable indicator of renal failure.