A Cautionary Tale of Replenishing Fluids in Post-Obstructive Diuresis

Post-obstructive diuresis is a response initiated by the kidneys after relief of a ureteral obstruction to eliminate accumulated salt and fluid. Studies suggest that 0.5% to 52% of patients experience post-obstructive diuresis after relief of an obstruction1. Urine output of 200 mL/hour for two consecutive hours or 3L/24 hours after relief of an obstruction is diagnostic2. In most patients the diuresis resolves on its own once the kidneys normalize the volume and solute status. However, diuresis will continue in some patients after homeostasis is reached, leading to pathologic post-obstructive diuresis, which puts patients at risk for severe dehydration, metabolic acidosis, electrolyte imbalances, hypovolemic shock, and death if fluid and electrolytes are not adequately replaced2.
Source: The American Journal of Medicine - Category: General Medicine Authors: Source Type: research