Which urinary change may occur near the end of life?

• A. Incontinence or anuria (increase or decrease in urine)
• B. Marked polyuria
• C. Large volumes of urine regularly
• D. No change in urine at all

Answer: (A)

As death approaches, the urinary system often shows changes because kidney perfusion and bladder control decline. Reduced renal blood flow and dehydration can lead to little or no urine production (oliguria or anuria), and relaxation of the urinary sphincter with decreased consciousness can result in urinary incontinence. The option that notes either incontinence or anuria best captures this variability and is the most accurate description of what may occur near end of life.

Polyuria or large, steady volumes of urine are not typical when the body’s systems are winding down, as fluid conservation and reduced kidney function usually decrease urine output. A scenario with no change in urine is also unlikely given the common decline in renal function and bladder control at this stage.