Monsoon fever and reduced urine: When should you worry?

The rainy season is both a respite from the heat and a time that creates some situations for many diseases, including dengue, malaria, leptospirosis, typhoid, and viral diseases. Over the rainy season, infections exhibit symptoms like fever, aches, fatigue, and decreased appetite, which can be managed using rest, hydration, and medical treatment. One significant symptom that should not be ignored is low urine output. Low urine output can denote dehydration, given that fever, sweating, vomiting, or diarrhoea can occur concurrently. When that happens, however, low urine output might indicate that the kidneys are receiving an insufficient blood supply or that their functioning may be impaired.

Why does fever reduce urine output?

When an individual has a fever, he/she may lose large amounts of fluid due to sweating and the faster rate of breathing. Instead, a person may not drink enough fluid due to nausea, lack of appetite, weakness, or vomiting. As a result, dehydration can occur, which decreases the blood supply to the kidneys. To protect itself, the kidneys may conserve water in the body; thus, the amount of urine secreted will decrease. Persistent stress may give rise to acute kidney injury (AKI), which is defined as a sudden fall in kidney function. This takes place in cases of serious infections, dehydration, low blood pressure, and problems with circulation. Hence, it is considered important to find out not only whether the urine output has decreased, but also how much it dropped, how long it remained low, and whether there are other symptoms present.

When should you be concerned?

If a person with fever has urine output that is much lower than what is considered normal, especially when this decrease persists despite adequate fluid intake, one should seek medical attention. This becomes particularly concerning if the reduction in urine output is accompanied by other symptoms such as persistent vomiting or diarrhoea, severe weakness or dizziness, stomach pain, excessive thirst or dehydration, urine that is very dark or viscous, swelling of the legs, feet or face, difficulty breathing, drowsiness or confusion, bleeding from the gums or nose, blood in urine or stools, clammy skin or blood pressure drop. There may be a need for extra monitoring for behaviours related to kidney problems, diabetes or other chronic diseases. Older people are especially vulnerable to suffering from dehydration-related complications.

What tests may be required?

Physicians may evaluate hydration and circulation in conjunction with blood pressure, heart rate and urine output. Depending on the clinical picture, tests can involve a full blood count, serum creatinine, blood urea, electrolytes, and urine analysis. It is essential to keep in mind that urine output alone does not give the complete picture for diagnosis.

Avoid self-medication and excessive fluids

Individuals dealing with monsoon fever generally prefer handling the symptoms at home. Even though it is important to maintain adequate hydration levels in the body, simply drinking too much water or other types of fluids is not recommended in case of impaired kidney function or fluid retention. In the same way, drugs should only be taken following medical advice. Certain painkillers, especially those of the NSAID family, must not be taken when one is dehydrated, as those drugs could increase the chances of kidney complications.

During monsoon, fever is common, but a fever along with a noticeable decline in urine output should not be taken lightly as simple dehydration. Early evaluation can help to distinguish between normal dehydration and acute kidney failure. If the urine output continues to fall or if it is associated with vomiting, diarrhoea, intense abdominal pain, difficulty in breathing, swelling, dizziness, or a change in consciousness, immediate evaluation should be sought.

The author is the Director and HOD, Nephrology and Kidney Transplant, at Aakash Healthcare Multi-Speciality Hospital, Dwarka. 

 

The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.