Normal urine output (minimum): 0.5 to 1 ml/kg/hr daily

Oliguria: < 500 ml urine/ 24 hours

Anuria: < 100 ml urine/ 24 hours. Low urine output: potential causes Prerenal: heart failure, shock, volume depletion, third spacing fluids, renal artery compromise Renal: acute tubular necrosis, end-stage renal disease, interstitial disease, glomerular disease, drug induced: (Aminoglycosides, amphotericin B, cisplatin, colistin, cyclosporin, dextran, gallium, hydroxyurea, lithium, methicillin, methotrexate, methoxyflurane, nitrofurantoin, pentamidime, plicamycin, streptozocin, and vancomycin.), bilateral cortical necrosis Post-renal: neurogenic bladder, obstruction of ureter, bladder neck, or urethra. Differential diagnosis Lab pre-renal renal Urine/serum creatinine >40 <20 fractional excreted sodium:

[UNa/serum Na] / [Ucr/ serum creatinine] x 100 <1 >1 Urine osmolality >500 <350 Urinary sodium <20 >40 Normal values: Appearance straw or yellow colored / clear Specific gravity: infant: 1.002 - 1.006

child and adult: 1.001 - 1.035 pH Child and adult: 4.6 - 8 Following substances should be negative: acetone, bilirubin, blood, glucose, nitrite, protein, leukocyte esterase. WBC 0 - 4/HPF RBC Male: 0 - 3/HPF female: 0 - 5/HPF Epithelial Occasional Hyaline casts Occasional Bacteria None Differential diagnosis: Bilirubin Positive hepatitis, obstructive jaundice Blood Positive tumors, infection, trauma, hemolytic anemia, coagulopathy, interstitial nephritis, polycystic kidneys, kidney stones, burns, cystitis, prostatitis, pyelonephritis Epithelial cells Positive acute tubular necrosis, necrotizing papillitis Glucose Positive diabetes, cushing's disease, burns, steroids, hyperthyroidism, pancreatitis, pancreatic carcinoma, shock Ketones Positive diarrhea, vomiting, DKA, starvation, high fat diet, hyperthyroidism, pregnancy, febrile states. Leukocyte esterase (detects 5 or > WBC).

Used along with test for nitrites to detect UTI (predictive capacity: approximately 74 %). If both nitrites and leukocyte esterase are negative, there is a 97% chance that a UTI is not present. Positive Infection Nitrite Positive Infection present. Nitrates are converted to nitrites by many strains of bacteria. Protein Positive glomerulonephritis, pyelonephritis, nephrotic syndrome, pre-eclampsia, malignancies, heavy exercise, stress, CHF, malignant hypertension