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Introduction: Psychic anuria is an old term, referring to a very rare psycho-urological event that has scarcely been studied so far., Materials and Methods: A retrospective study of the patients with psychic anuria presented to Assiut Urology and Nephrology Hospital during the period July 1991-June 2016 was done. Psychic anuria was defined, and the demographic and clinical characteristics including the methods of diagnosis and management were studied., Results: Of more than 3,800 cases of anuria, 9 female patients (0.24%) experienced psychic anuria in the age range of 17-43 years. Cardinal clinical findings included anuria for 36-72 h with absence of organic causes and normal renal function tests. Psychosocial risk factors were reported in the 9 cases. Anuria was documented by reliable history (56%) or observable urine collection (44%). Diagnosis was done by exclusion, where the investigations revealed no organic causes. Seven cases responded to the placebo intervention and 2 cases were self-limiting and resolved spontaneously., Conclusions: Psychic anuria is an extremely rare urological emergency that presents, mainly, in young adult females with unknown mechanisms. Renal vasoconstriction following psychosocial stressors is suggested. It is diagnosed by exclusion and resolves spontaneously or responds to placebo intervention as a mental distraction technique., (© 2018 S. Karger AG, Basel.)

Residual renal function (RRF) impacts on patient survival and quality of life of dialysis patients. Its longer preservation is a major advantage of peritoneal dialysis (PD) and should be also a target of adequacy, beyond Kt/V. Anuric patients no longer benefit from such PD advantage, depending only on dialysis schedule to achieve adequate small solute and volume control. This challenge can be successfully dealt with by using automated PD, icodextrine, low-glucose degradation products and individualized PD profiles. There is evidence that PD advances allow nowadays satisfactory patient survival while keeping the benefits of home dialysis and preserving vascular network. An integrated care plan should consider both medical indications and patient preference aiming for the longer total patient survival, even if transfer to HD might be later needed as part of individualized renal replacement strategy.