[45F] With decreased urination and anhidrosis

Patient Description

A 45-year-old female reports a sudden onset of significantly decreased urination over the past 5 days, despite increasing water intake to at least a gallon per day. She urinates approximately 6 times a day but only in small amounts, with urine that is very dark orange in color. She also notes that she has not been sweating for the past day despite being in a hot environment. The patient has a history of kidney stones and frequently experiences difficulty fully emptying her bladder, often needing to push hard to urinate completely. There is no pain or discomfort while urinating, and no swelling in the legs, ankles, or feet.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few serious conditions that could be causing your decreased urination and lack of sweating:

  1. Acute Kidney Injury (AKI): This is a sudden episode of kidney failure or kidney damage that happens within a few hours or days. It causes waste products to build up in your blood and makes it hard for your kidneys to keep the right balance of fluid in your body. Given your history of kidney stones, this could be a contributing factor. Typical treatments include hospitalization, intravenous fluids, and medications to manage the underlying cause.

  2. Severe Dehydration: Despite drinking a lot of water, your body might not be absorbing it properly, leading to severe dehydration. This can cause your urine to become very concentrated and dark in color. Treatment usually involves rehydration through oral or intravenous fluids.

  3. Urinary Tract Obstruction: A blockage in your urinary tract, possibly due to kidney stones, could be preventing urine from passing normally. This can lead to decreased urination and dark-colored urine. Treatment often involves removing the obstruction, which may require medical procedures or surgery.

  4. Heat Stroke: Lack of sweating in hot conditions is a serious sign of heat stroke, which is a medical emergency. This condition can cause your body to overheat, leading to organ damage. Immediate cooling and medical attention are crucial.

What you can do

  1. Seek Immediate Medical Attention: Given the severity of your symptoms, you should seek immediate medical attention. Go to the nearest emergency room or urgent care center. If you feel light-headed, dizzy, or your symptoms worsen, call 911 or have someone drive you to the hospital immediately.

  2. Stay Hydrated: Continue to drink plenty of water, but be aware that this alone may not resolve the issue if your body is not absorbing the fluids properly.

  3. Avoid Heat Exposure: Stay in a cool environment and avoid strenuous activities to prevent further dehydration and overheating.

  4. Monitor Symptoms: Keep track of any additional symptoms such as pain, swelling, or changes in your condition, and report these to the healthcare provider.

Remember, while I can provide information based on your symptoms, only a healthcare professional can give you a formal diagnosis and appropriate treatment. Please seek care immediately to ensure your health and safety.

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4 mo ago

People Also Ask


What are the common symptoms of acute kidney injury (AKI)?

Common symptoms of acute kidney injury include decreased urine output, fluid retention causing swelling in legs, ankles, or feet, fatigue, confusion, nausea, and chest pain or pressure. It's important to seek medical attention if you suspect AKI.


How can severe dehydration occur even with high water intake?

Severe dehydration can occur if the body is not absorbing water properly, which can happen due to factors like electrolyte imbalances, certain medications, or underlying health conditions. This can lead to concentrated, dark urine despite high water intake.


What are the signs of a urinary tract obstruction?

Signs of a urinary tract obstruction include difficulty urinating, decreased urine output, dark or cloudy urine, and sometimes pain in the lower abdomen or back. Medical evaluation is necessary to determine the cause and appropriate treatment.


What should I do if I suspect I have heat stroke?

If you suspect heat stroke, it's crucial to seek immediate medical attention. Move to a cooler place, remove excess clothing, and try to cool down with water or ice packs. Avoid drinking caffeinated or alcoholic beverages, and call emergency services if symptoms are severe.


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