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Detrusor Underactivity Model in Rats by Conus Medullaris Transection
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Published on: August 28, 2020

Reflex anuria: an old concept with new evidence.

Weibin Hou1, Jin Wen, Zhigang Ji

  • 1Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1#, Shuaifuyuan, Dongcheng District, Beijing, 100730, People's Republic of China.

International Urology and Nephrology
|August 28, 2013
PubMed
Summary

Reflex anuria (RA) is a rare condition where urine output stops due to stimuli on the kidneys or ureters. It involves reflex spasms, leading to functional acute kidney injury.

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Area of Science:

  • Nephrology
  • Urology
  • Physiology

Background:

  • Reflex anuria (RA) is a poorly understood condition, proposed over 50 years ago.
  • Mechanisms like intrarenal arteriolar spasm and ureteral spasm are accepted causes of RA.
  • RA is a diagnosis of exclusion, requiring ruling out other renal pathologies.

Purpose of the Study:

  • To review existing literature on reflex anuria.
  • To elucidate the pathogenesis and general profile of RA.
  • To propose a classification system for RA.

Main Methods:

  • Comprehensive literature review of papers on RA.
  • Analysis of proposed mechanisms: intrarenal arteriolar spasm and ureteral spasm.
  • Development of a classification system based on stimulus origin and reflex pathways.

Main Results:

  • A classification system for RA was proposed, including neurovascular, ureterorenal, radiated renovascular, renoureteral, ureteroureteral, and radiated ureteral reflexes.
  • Evidence supports all proposed types except renoureteral reflex from animal and clinical studies.
  • Autonomic nervous system abnormalities and congenital urogenital malformations are predisposing factors for RA.

Conclusions:

  • RA is characterized by urine production cessation due to reflex spasms, resulting in functional acute renal failure.
  • Treatment should target the underlying reflex mechanisms rather than solely the causative factors.
  • RA is a functional disorder, not a parenchymal disease of the kidneys.