Why Do Kidney Failure Patients with Dialysis Stop Urinating

In order to survive, some kidney failure patients choose to do the dialysis. While, they surprised to find that they still stop urinating. What should they do?

Although the glomerular filtration rate (GFR) is very low in patients with end-stage kidney disease (ESKD), the urine output is variable, ranging from oliguria to normal or even above normal levels. These findings are related to the fact that the urine output is determined not by the GFR alone, but also by the difference between the GFR and the rate of tubular reabsorption. If, for example, a patient with advanced acute or chronic kidney failure has a GFR of 5 L/day (versus the normal of 140 to 180L/day), the daily urine output will still be 1.5 L if only 3.5 L of the filtrate is reabsorbed.

It had been thought that tubular damage impaired the ability to reabsorb sodium and water, thereby contributing to the maintenance of an adequate urine output in this setting. However, it seems more likely that volume expansion (due to initial sodium retention) and a urea osmotic diuresis (as the daily urea load is excreted by fewer functioning nephrons), due in part to solute intake, play a more important role in the persistent urine output .

In comparison, water intake (which usually determines the urine output via changes in the secretion of antidiuretic hormone [ADH]) plays relatively little role in regulating the urine output in advanced kidney disease. These patients can neither dilute nor concentrate the urine normally; the range of urine osmolality that can be achieved may vary from a minimum of 200mosmol/kg to a maximum of 300 mosmol/kg, compared with 50 to 1200mosmol/kg in normal subjects . The net effect of this ADH resistance is that variations in ADH release in response to changes in water intake have relatively little effect on the urine output .


Please don’t worry it too much, because there are a lot of the Chinese medical treatments can help the kidney failure patients produce the urine. Such as the micro-Chinese medicine osmotehrapy. If you want to know more information about it, you can send emails to kidneyhospitalabroad@hotmail.com or add my whatsapp +86 13383015760.