Decreased Urine Output: Causes, Treatment, and Prevention

There are many reasons why a man or woman might have a decreased or low urine output. 

Chief among the causes are dehydration due to vomiting, fever, diarrhea due to illness, or a simple lack of adequate fluid intake. 

Of course, the last item is easily remedied by consuming more hydrating fluids, but some of the other things are more serious and require attention. 

What is decreased urine output?

Decreased urine output is medically known as oliguria. 

It is generally defined as less than 13.5 fluid ounces (400 ml) of urine per day.  Oliguria can also be caused by an acute kidney injury or renal failure. 

How to measure kidney function

A test used by doctors to measure the level of kidney function is the estimated glomerular filtration (GFR) rate. 

It is calculated from the results of a blood test that measures creatinine, as well as a person′s age, body size, and sex. 

The GFR rate typically drops with age. 

An average level for a healthy adult is anything over 90. The level tends to decrease as you age. 

Levels below 60 for aging adults usually indicate the kidneys are not working as well as they should. 

The creatinine blood test is a rough indicator of how well the kidneys work at removing wastes and excess fluid from the blood. 

A level greater than 1.2 for women or more than 1.4 for men may be an early sign of beginning kidney disease. 

As it progresses, creatinine blood levels tend to rise. 

Causes of Decreased Urine Output

Standard urine output is typically 1.5 to 2 mL/kg per hour or about 8 to 9 oz per hour for a 150 lb person. 

Dehydration

If urine output is less than this and there is no other apparent cause, it is likely due to dehydration, and drinking more fluids is an immediate remedy. 

Infection or Obstruction

Significantly darker or bloody urine may indicate a serious problem that needs medical attention.

Decreased urination can also be due to infection or obstruction in the bladder or urinary tract. 

Medications

Sometimes urination problems can be caused by certain medications. 

Some medications that are known to reduce urine production include:

• Nonsteroidal anti-inflammatory drugs (NSAID′s)
• Blood pressure medications such as ACE inhibitors
• Various antibiotics

Kidney Injury

The kidney’s job is to filter the blood and remove waste products. 

Decreased urine output that is not due to obvious dehydration may be a serious problem. 

A kidney injury that hampers urine output may have occurred due to a previous illness, surgery, or long-term prostate condition.

Each filter in the kidney is called a glomerulus, and the overall rate of the kidney’s reduction of the body’s waste is called the glomerular filtration rate or GFR. 

The glomerular filtration rate may fall to shallow levels in patients with acute kidney injury. 

However, a low glomerular filtration rate is not necessarily associated with a parallel reduction in urine output, varying from oliguria to typical values. 

Low Blood Pressure

Certain illnesses can cause a temporary decrease in blood pressure. 

This is usually insignificant, but chronic low blood flow can reduce the blood flowing through the filters and less blood flow through the kidneys and, thus, less urine formation. 

This issue, while relatively rare, is often due to reduced cardiac output, severe dehydration, a decreased volume of circulating blood in the body (hypovolemia), hemorrhage, cardiac failure, an increase in the systemic inflammatory response, or sepsis. 

Tubular necrosis

Tubular necrosis is a condition that causes reduced blood flow to the kidneys. 

It can occur from any condition that causes a lack of renal oxygen and blood flow. 

These tube-shaped structures in the kidneys, called tubules, help filter out waste products. 

These structures may be damaged due to long-term blood flow restrictions and cause necrosis, or decreased renal perfusion, thus damaging kidney efficiency. 

Benign Prostate Hyperplasia (BPH)

Men with benign prostate hyperplasia (BPH) can sometimes encounter a complete urinary blockage and inability to void any urine. 

This typically occurs in the early hours of the morning. 

It is usually a medical emergency necessitating a trip to the hospital emergency room. 

Long-term incomplete emptying of the bladder is a common side effect of BPH. 

The incomplete draining of the bladder can cause excessive back pressure on the kidneys and kidney injury, as well as complete kidney failure.

Improving Urine Output

Several ways to improve urinary output for a man with BPH are as follows: 

• Stay active. Lack of physical activity can exacerbate urine retention
• Learn to do Kegel exercises. 
• Double void. A technique where waiting a few minutes after voiding may help bladder muscles relax and emptying more urine. 
• Meditate. Nervous tension can cause an increased need to void with little results.

Men with BPH can often be helped with urinary difficulties using natural or prescription medications. 

See a natural health practitioner or a holistic medical doctor for advice on various products that might help. 

Chronic BPH can result in urinary retention where urination tends to be sparse. 

This leaves the bladder full or near full most of the time, and causes back pressure on the kidneys. 

Over time urinary retention from this can cause kidney disease, kidney injury, and kidney failure.

Treatment and Prevention

Depending on the underlying cause and severity, some types of kidney disease can be treated. 

However, once the disease has progressed to a severe, chronic state, there is often no cure. 

Treatment usually consists of trying to control symptoms, reduce complications, and slow the progression of the disease. 

Once the kidneys are severely damaged, few treatments are available.  

The most usual cause for low urine volume is dehydration. It is also the most easily correctable issue. 

Simply drinking more fluids will help solve the problem. 

In severe cases, it may be necessary to introduce fluids into the body using intravenous introduction (IV). 

This is where liquids are introduced through a tube that puts fluid directly into a vein in the hand or arm. 

Often, to prevent dehydration, doctors will use diuretic medications or loop diuretics to increase urine flow. Severe dehydration can lead to shock, sepsis, or death. 

Shock is a medical emergency and requires immediate medical attention.

Kidney dialysis is a viable treatment but is usually used only in chronic cases. 

Dialysis artificially removes waste products and extra fluid from your blood when your kidneys can no longer do it. 

It is a process where a machine filters waste and excess fluids from your blood to do the kidneys’ job. 

Finally, a kidney transplant may be the only viable option. 

It involves surgically replacing a kidney with a healthy one from a donor, sometimes a deceased person but often a living relative as a donor. 

However, a transplant will require anti-rejection medications for life to keep the body from rejecting the transplanted organ. 

When To See A Doctor For Decreased Urine Output

The best way to treat kidney disease is to prevent it from occurring. 

Medical doctors can offer many ways to help change lifestyle and diet to help reduce kidney problems. Ideally, urine should be a pale yellow color if your hydration level is normal. 

The darker urine is, the more concentrated it is. 

Older men with prostate issues often see small amounts of blood in their urine, especially men with severe BPH or other prostate issues.

While dark urine is most commonly due to dehydration, it may indicate that excess, unusual, or potentially dangerous waste products are circulating in the body. 

For example, dark brown urine may indicate liver disease due to the presence of bile in the urine. Light brown or reddish-colored urine may be an indication of bleeding in the bladder or urinary system. 

For an adult, urine output is about 13.5 ounces over 24 hours. Much less may indicate a problem.

Conclusion

People with chronic kidney disease may retain fluids. 

This can lead to swelling in the legs, as well as high blood pressure. 

Medications called diuretics can help maintain the balance of fluids in your body. 

People that eat high-protein diets, especially diets that get the bulk of their protein from red meats, are at a higher risk of developing kidney disease. 

As the body processes protein from foods, it creates waste products that the kidneys must filter from the blood. 

A lower protein diet can help reduce these waste products, thus reducing the workload for the kidneys. 

A natural health practitioner, a dietitian, or a nutritionist may be able to suggest ways to adjust your diet to lower the risk of kidney problems. 

Kidney disease is a serious illness that can eventually result in death. 

Prevention is the best way to deal with it, but it is best to deal with it expeditiously if it occurs. 

The earlier it is detected, the better the chance of slowing or stopping its progression.

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