RENAL PROBLEMS AND CRITICAL CARE: KEY POINTS

Key Points

1. Anuria is post renal obstruction until otherwise proven

2. Obstruction to the urinary outflow tract is usually due to external compression, or surgical injury.

3. Oliguria is hypotension or hypoperfusion until otherwise proven.

4. Oliguria is acute renal success, explained physiologically by the triad of: renal autoregulation, renal medullary hypoxia and  tubuloglomerular feedback.

5. If medullary blood flow falls below 20% of normal, cell death occurs.

6. The stress response to surgery may cause inappropriate urinary retention.

7. Perioperative renal injury may occur due to rhabdomyolysis and other nephrotoxins

8. Allergic renal injuries may be caused by drugs, particularly penicillins (acute interstitial nephritis).

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