Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2020 Apr 23;24(1):171.
doi: 10.1186/s13054-020-02858-x.

The clinical relevance of oliguria in the critically ill patient: analysis of a large observational database

Jean-Louis Vincent  1 , Andrew Ferguson  2 , Peter Pickkers  3 , Stephan M Jakob  4 , Ulrich Jaschinski  5 , Ghaleb A Almekhlafi  6 , Marc Leone  7 , Majid Mokhtari  8 , Luis E Fontes  9 , Philippe R Bauer  10 , Yasser Sakr  11 ; ICON Investigators
Collaborators, Affiliations
Observational Study

The clinical relevance of oliguria in the critically ill patient: analysis of a large observational database

Jean-Louis Vincent et al. Crit Care. .

Abstract

Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output < 0.5 ml/kg/h) in acutely ill patients and its association with the need for renal replacement therapy (RRT) and outcome.

Methods: International observational study. All adult (> 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis.

Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient-oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged-oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent-oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103).

Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.

Keywords: Mortality; Renal replacement therapy; Urine output.

PubMed Disclaimer

Conflict of interest statement

Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution.

JLV is the Editor-in-Chief of Critical Care.

The other authors declare that they have no relevant financial interests.

Figures

Fig. 1
Fig. 1
Flow chart of patients included in study
See this image and copyright information in PMC

References

    1. Macedo E, Malhotra R, Bouchard J, Wynn SK, Mehta RL. Oliguria is an early predictor of higher mortality in critically ill patients. Kidney Int. 2011;80:760–767. doi: 10.1038/ki.2011.150. - DOI - PubMed
    1. Prowle JR, Liu YL, Licari E, Bagshaw SM, Egi M, Haase M, et al. Oliguria as predictive biomarker of acute kidney injury in critically ill patients. Crit Care. 2011;15:R172. doi: 10.1186/cc10318. - DOI - PMC - PubMed
    1. Vaara ST, Parviainen I, Pettila V, Nisula S, Inkinen O, Uusaro A. Association of oliguria with the development of acute kidney injury in the critically ill. Kidney Int. 2016;89:200–208. doi: 10.1038/ki.2015.269. - DOI - PubMed
    1. Kidney Disease Outcomes Quality Initiative KDIGO clinical practice guidelines for acute kidney injury. Kidney Int Suppl. 2012;2:1–138. doi: 10.1038/kisup.2012.1. - DOI
    1. Vincent JL, Moreno R, Takala J, Willatts S, de Mendonca A, Bruining H, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996;22:707–710. doi: 10.1007/BF01709751. - DOI - PubMed

Publication types

MeSH terms