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Polyuria

Polyuria
Regulation of urine production by ADH and aldosterone
Classification and external resources
Specialty Endocrinology, nephrology
ICD-10 R35
ICD-9-CM 788.42
MedlinePlus 003146
MeSH D011141

Polyuria is a condition usually defined as excessive or abnormally large production or passage of urine (greater than 2.5[1] or 3[2] L over 24 hours in adults). Frequent urination is sometimes included by definition but is nonetheless usually an accompanying symptom. Increased production and passage of urine may also be termed diuresis.[3][4] Polyuria often appears in conjunction with polydipsia (increased thirst), though it is possible to have one without the other, and the latter may be a cause or an effect. Psychogenic polydipsia may lead to polyuria. [5]

Contents

  • Causes 1
    • List of causes 1.1
  • Mechanism 2
  • Treatment 3
  • See also 4
  • References 5
  • Further reading 6

Causes

The most common cause of polyuria in both adults and children is uncontrolled diabetes mellitus,[2] which causes osmotic diuresis, when glucose levels are so high that glucose is excreted in the urine. Water follows the glucose concentration passively, leading to abnormally high urine output. In the absence of diabetes mellitus, the most common causes are excessive secretion of aldosterone due to adrenal cortical tumor, primary polydipsia (excessive fluid drinking), central diabetes insipidus and nephrogenic diabetes insipidus.[2] Polyuria may also be due to various chemical substances, such as diuretics, caffeine, and ethanol. It may also occur after supraventricular tachycardias, during an onset of atrial fibrillation, childbirth, and the removal of an obstruction within the urinary tract. Diuresis is controlled by antidiuretics such as vasopressin, angiotensin II and aldosterone. Cold diuresis is the occurrence of increased urine production on exposure to cold, which also partially explains immersion diuresis. High-altitude diuresis occurs at altitudes above 10,000 feet (3,000 m) and is a desirable indicator of adaptation to high altitudes. Mountaineers who are adapting well to high altitudes experience this type of diuresis. Persons who produce less urine even in the presence of adequate fluid intake are probably not adapting well to altitude.

List of causes

Urinary tract infection( bacteria is black and bean-shaped)
Emphysematous cystitis
General

Urinary system

Hormonal

Circulation

Neurologic

Other

Mechanism

Polyuria in osmotic cases, increases flow amount in the distal nephron where flow rates and velocity are low.The significant pressure increase occurring in the distal nephron takes place particularly in the cortical-collecting ducts. This study develops a hypothesis where hyperglycaemic,and osmotic polyuria play roles, ultimately, in diabetic nephropathy.[36]

Treatment

Depending on the cause of the polyuria, the adequate treatment should be afforded. According to NICE, desmopressin can be considered for nocturnal polyuria, which can be caused by diabetes mellitus,[37] if other medical treatments have failed. The recommendation had no studies that met the criteria for consideration.[38]

See also

References

  1. ^ "Urination - excessive amount". Medline Plus. United States National Library of Medicine. 27 December 2013. Retrieved 30 December 2014. 
  2. ^ a b c "Polyuria". Merck Manuals. November 2013. Retrieved 30 December 2014. 
  3. ^ "Definition of Diuresis". MedTerms. 30 October 2013. Retrieved 30 December 2014. 
  4. ^ "Diuresis". The Free Dictionary. Retrieved 30 December 2014. 
  5. ^ Parthasarathy, A. (2014-04-30). Case Scenarios in Pediatric and Adolescent Practice. JP Medical Ltd.  
  6. ^ Rippe, editors, Richard S. Irwin, James M. (2008). Irwin and Rippe's intensive care medicine (6th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 909.  
  7. ^ Rudolf, Mary (2006). Paediatrics and Child Health (2nd ed.). Wiley. p. 142. Retrieved 5 August 2015. 
  8. ^ Ronco, Claudio (2009). Critical Care Nephrology (2nd ed.). Saunders. p. 475. Retrieved 5 August 2015. 
  9. ^ Paulman, Paul (2012). Signs and Symptoms in Family Medicine: A Literature-Based Approach. Elsevier. p. 432. Retrieved 5 August 2015. 
  10. ^ Drake, edited by Michael Glynn, William M. (2012). Hutchison's clinical methods : an integrated approach to clinical practice. (23rd ed.). Edinburgh: Elsevier. p. 378.  
  11. ^ Lee, [edited by] Mary (2013). Basic skills in interpreting laboratory data (5th ed.). Bethesda, Md.: American Society of Health-System Pharmacists. p. 132.  
  12. ^ Weissman, [edited by] Barbara N. (2009). Imaging of arthritis and metabolic bone disease. Philadelphia, PA: Mosby/Elsevier. p. 679.  
  13. ^ Radiology illustrated : pediatric radiology (1., 2013 ed.). [S.l.]: Springer. 2013. p. 761.  
  14. ^ Chihan, Nina (2007). Nursing Interpreting Signs and Symptoms. Lippincott Williams & Wilkins. p. 481. Retrieved 5 August 2015. 
  15. ^ Brickell, [edited by] Wendy Arneson, Jean (2007). Clinical chemistry : a laboratory perspective. Philadelphia: F.A. Davis Co. p. 411.  
  16. ^ Soni, Andrew Bersten, Neil (2013). Oh's Intensive Care Manual. (7. ed.). London: Elsevier Health Sciences. p. 643.  
  17. ^ "Pediatric Pheochromocytoma Clinical Presentation". Medscape.com. eMedicine. Retrieved 6 August 2015. 
  18. ^ Ghosh, Srinanda (2007). MCQ's in medical surgical nursing : (with explanatory answers) (1st ed.). New Delhi, India: Jaypee Bros. Medical Publishers (P) Ltd. p. 150.  
  19. ^ Loscalzo, edited by Ajay K. Singh, Joseph (2014). The Brigham intensive review of internal medicine (Second ed.). p. 551.  
  20. ^ Acute medicine 201415. [S.l.]: Scion. 2014. p. 312.  
  21. ^ Mariani, Laura (2007). "The Renal Manifestations of Thyroid Disease". Journal of the American society of Nephrology: 22–26. Retrieved 6 August 2015. 
  22. ^ "Panhypopituitarism Clinical Presentation". Medscape.com. eMedicine. Retrieved 6 August 2015. 
  23. ^ Kost, Michael (2004). Moderate sedation/analgesia : core competencies for practice (2nd ed.). St. Louis, Missouri.: Saunders. p. 43.  
  24. ^ Schwartz, editor, M. William Schwartz ; associate editors, Louis M. Bell, Jr. ... [et al.] ; assistant editor, Charles I. (2012). The 5-minute pediatric consult (6th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 270.  
  25. ^ Abrams, Paul (2006). Urodynamics (3. ed.). London: Springer. p. 120.  
  26. ^ Leslie, Shern L. Chew, David (2006). Clinical endocrinology and diabetes. Edinburgh: Churchill Livingstone/Elsevier. p. 21.  
  27. ^ Pavord, Sherif Gonem ; foreword by Ian (2010). Diagnosis in acute medicine. Oxford: Radcliffe Pub. p. 44.  
  28. ^ Shanley, edited by Derek S. Wheeler, Hector R. Wong, Thomas P. (2014). A Systems Approach. (2nd ed.). Springer Verlag. p. 635.  
  29. ^ Parker, Rolland S. (2012). Concussive brain trauma neurobehavioral impairment and maladaptation (Second ed.). Boca Raton, FL: CRC Press. p. 322.  
  30. ^ "Migraine Headache Clinical Presentation". Medscape.com. eMedicine. Retrieved 6 August 2015. 
  31. ^ McKee, Mitchell Bebel Stargrove, Jonathan Treasure, Dwight L. (2008). Herb, nutrient, and drug interactions : clinical implications and therapeutic strategies. St. Louis, Mo.: Mosby/Elsevier. p. 267.  
  32. ^ Watkins, edited by W. Allan Walker, John B. (1997). Nutrition in pediatrics : basic science and clinical application (2nd ed.). Hamilton, Ont.: B.C. Decker. p. 205.  
  33. ^ Swienton, editors, Richard B. Schwartz, John G. McManus Jr., Raymond E. (2008). Tactical emergency medicine. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. p. 75.  
  34. ^ Vyas, JN (2008). Textbook of Postgraduate Psychiatry (2 Vols.). Jaypee Brothers Publishing. p. 761.  
  35. ^ "Hemochromatosis Clinical Presentation". Medscape.com. eMedicine. Retrieved 6 August 2015. 
  36. ^ Wang, Shinong; Mitu, Grace M.; Hirschberg, Raimund (2008-07-01). "Osmotic polyuria: an overlooked mechanism in diabetic nephropathy". Nephrology Dialysis Transplantation 23 (7): 2167–2172.  
  37. ^ Merseburger, Axel S.; Kuczyk, Markus A.; Moul, Judd W. (2014-10-21). Urology at a Glance. Springer.  
  38. ^ "Nocturia and nocturnal polyuria in men with lower urinary tract symptoms: oral desmopressin | key-points-from-the-evidence | Advice | NICE". www.nice.org.uk. Retrieved 2015-08-03. 

Further reading

  • Movig, K. L. L.; Baumgarten, R.; Leufkens, H. G. M.; Laarhoven, J. H. M. Van; Egberts, A. C. G. (2003-04-01). "Risk factors for the development of lithium-induced polyuria". The British Journal of Psychiatry 182 (4): 319–323.  
  • Kreder, Karl; Dmochowski, Roger (2007-07-10). The Overactive Bladder: Evaluation and Management. CRC Press.  
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