International Urology and Nephrology

, Volume 46, Issue 2, pp 323–328

Reflex anuria: an old concept with new evidence

  • Weibin Hou
  • Jin Wen
  • Zhigang Ji
  • Jian Chen
  • Hanzhong Li
Urology – Review

DOI: 10.1007/s11255-013-0541-9

Cite this article as:
Hou, W., Wen, J., Ji, Z. et al. Int Urol Nephrol (2014) 46: 323. doi:10.1007/s11255-013-0541-9

Abstract

Reflex anuria (RA) was defined by Hull as cessation of urine output from both kidneys due to irritation or trauma to one kidney or its ureter, or severely painful stimuli to other organs. This is not a common concept among urologists or nephrologists even though it has been proposed for more than half a century. The phenomenon has not been thoroughly understood. But intrarenal arteriolar spasm and ureteral spasm have gained wide acceptance as the mechanisms of RA. The present review summarized papers published up to now on RA, in order to depict the general profile of the disease and to further elucidate the pathogenesis of RA. A classification system of RA was proposed as neurovascular reflex, ureterorenal reflex, radiated renovascular reflex, renoureteral reflex, ureteroureteral reflex and radiated ureteral reflex, based on the two assumed mechanisms and the stimulus’ origins. All these types except renoureteral reflex had gained supporting evidence from animal experiments and/or clinical case reports. RA is a diagnosis of exclusion, only being considered after ruling out common and tangible etiologies such as ureteral calculi, acute tubular necrosis, renal vascular occlusion, hypovolemia, infection, etc. If the diagnosis has been established, treatment plan should be directed toward the mechanisms more than the causative factors. Abnormalities of the autonomic nerve system and congenital urogenital malformations incline people to RA. In summary, RA is a cessation of urine production caused by stimuli on kidney, ureter or other organs, through a mechanism of reflex spasm of intrarenal arterioles or ureters, leading to acute renal failure. It is a functional rather than parenchymal disease.

Keywords

Anuria Renal artery Ureteral colic Renal disease Oliguria 

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Weibin Hou
    • 1
  • Jin Wen
    • 1
  • Zhigang Ji
    • 1
  • Jian Chen
    • 1
  • Hanzhong Li
    • 1
  1. 1.Department of Urology, Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingPeople’s Republic of China

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