Excess urination
Medical condition
Polyuria (/ˌ p ɒ l i ˈ jʊər i ə passage ofurine (greater than 2.5 L[ 1] [ 6] diuresis .[ 7] [ 8] polydipsia (increased thirst), though it is possible to have one without the other, and the latter may be a cause or an effect.Primary polydipsia may lead to polyuria.[ 9] symptom orsign of anotherdisorder (not a disease by itself), but it can be classed as a disorder, at least when its underlying causes are not clear.[citation needed
The most common cause of polyuria in both adults and children is uncontrolleddiabetes mellitus ,[ 6] osmotic diuresis ; when glucose levels are so high thatglucose is excreted in the urine . Water follows the glucose concentration passively, leading to abnormally high urine output.[citation needed
In the absence of diabetes mellitus, the most common causes are the decreased secretion ofaldosterone due to adrenal cortical tumor,primary polydipsia (excessive fluiddrinking ),central diabetes insipidus , andnephrogenic diabetes insipidus .[ 6] diuretics ,caffeine , andethanol . It may also occur aftersupraventricular tachycardias , during an onset ofatrial fibrillation ,childbirth , and the removal of an obstruction within theurinary tract . Diuresis is controlled byantidiuretics such asvasopressin ,angiotensin II andaldosterone .Cold diuresis is the occurrence of increased urine production upon exposure to cold, which also partially explainsimmersion diuresis .High-altitude diuresis occurs at altitudes above 10,000 feet (3,000 m) and is a desirable indicator ofadaptation to high altitudes . Mountaineers who are adapting well to high altitudes experience this type of diuresis. People who produce less urine even in the presence of adequate fluid intake are probably not adapting well to high altitudes.[ 10]
Urinary tract infection (bacteria are black and bean-shaped) Emphysematous cystitis Lithium-carbonate General Urinary system
Hormonal
Circulation
Neurologic
Other
Polyuria, in osmotic cases, increases flow amount in the distalnephron where flow rates andvelocity are low. The significant pressure increase occurring in the distal nephron takes place particularly in the cortical-collecting ducts. One study from 2008 laid out a hypothesis that hyperglycaemic and osmotic polyuria play roles ultimately in diabetic nephropathy.[ 40]
Among the possible tests to diagnose polyuria are:[ 4]
Depending on the cause of the polyuria, the adequate treatment should be afforded. According toNICE , desmopressin can be considered for nocturnal polyuria, which can be caused by diabetes mellitus,[ 5] [ 41]
^a b "Urination – excessive amount" .Medline Plus . United States National Library of Medicine. 27 December 2013. Retrieved30 December 2014 .^a b Rudolf, Mary (2006).Paediatrics and Child Health ISBN 9781444320664 . Retrieved5 August 2015 . ^a b Irwin, Richard S.; Rippe, James M., eds. (2008).Irwin and Rippe's intensive care medicine ISBN 978-0-7817-9153-3 . Retrieved5 August 2015 . ^a b "Polyuria. Medical Professional reference for Polyuria. | Patient" .Patient . Retrieved2015-11-08 .^a b Merseburger, Axel S.; Kuczyk, Markus A.; Moul, Judd W. (2014-10-21).Urology at a Glance ISBN 9783642548598 ^a b c "Polyuria" .Merck Manuals . November 2013. Retrieved30 December 2014 .^ "Definition of Diuresis" .MedTerms . 30 October 2013. Retrieved30 December 2014 .^ "Diuresis" .The Free Dictionary . Retrieved30 December 2014 .^ Parthasarathy, A. (2014-04-30).Case Scenarios in Pediatric and Adolescent Practice ISBN 9789351520931 ^ Research, Institute of Medicine (US) Committee on Military Nutrition; Marriott, Bernadette M.; Carlson, Sydne J. (1996),"Fluid Metabolism at High Altitudes" ,Nutritional Needs in Cold and in High-Altitude Environments: Applications for Military Personnel in Field Operations , National Academies Press (US), retrieved2024-03-04 ^ Ronco, Claudio (2009).Critical Care Nephrology ISBN 978-1416042525 . Retrieved5 August 2015 . ^ Paulman, Paul (2012).Signs and Symptoms in Family Medicine: A Literature-Based Approach ISBN 978-0323081320 . Retrieved5 August 2015 . ^ Drake, William M.; Hutchison, Robert (2012).Hutchison's clinical methods : an integrated approach to clinical practice ISBN 978-0-7020-4091-7 . Retrieved5 August 2015 . ^ Lee, Mary (2013).Basic skills in interpreting laboratory data ISBN 978-1-58528-343-9 . Retrieved5 August 2015 . ^ Weissman, Barbara N. (2009).Imaging of arthritis and metabolic bone disease ISBN 978-0-323-04177-5 . Retrieved5 August 2015 . ^ Radiology illustrated : pediatric radiology ISBN 978-3-642-35572-1 . Retrieved6 August 2015 .^ Chihan, Nina (2007).Nursing Interpreting Signs and Symptoms ISBN 9781582556680 . Retrieved5 August 2015 . ^ Arneson, Wendy; Brickell, Jean, eds. (2007).Clinical chemistry: a laboratory perspective ISBN 978-0-8036-1498-7 OCLC 76901872 . Retrieved5 August 2015 . ^ Soni, Andrew Bersten, Neil (2013).Oh's Intensive Care Manual ISBN 978-0-7020-4762-6 . Retrieved6 August 2015 . {{cite book }}: CS1 maint: multiple names: authors list (link )^ "Pediatric Pheochromocytoma Clinical Presentation" .Medscape.com . eMedicine. Retrieved6 August 2015 .^ Ghosh, Srinanda (2007).MCQ's in medical surgical nursing : (with explanatory answers) ISBN 978-81-8448-104-4 . Retrieved6 August 2015 . ^ Singh, Ajay K.; Loscalzo, Joseph (2014).The Brigham intensive review of internal medicine ISBN 978-0-19-935828-1 . Retrieved6 August 2015 . ^ Acute medicine 201415 ISBN 978-1-907904-25-7 . Retrieved6 August 2015 .^ Mariani, Laura (2007)."The Renal Manifestations of Thyroid Disease" .Journal of the American Society of Nephrology .23 (1):22– 26.doi :10.1681/ASN.2010070766 PMID 22021708 . Retrieved6 August 2015 . ^ "Panhypopituitarism Clinical Presentation" .Medscape.com . eMedicine. Retrieved6 August 2015 .^ Kost, Michael (2004).Moderate sedation/analgesia : core competencies for practice ISBN 978-0-7216-0324-7 . Retrieved6 August 2015 . ^ Schwartz, M. William Schwartz; et al., eds. (2012).The 5-minute pediatric consult ISBN 978-1-4511-1656-4 . Retrieved6 August 2015 . ^ Abrams, Paul (2006).Urodynamics ISBN 978-1-85233-924-1 . Retrieved6 August 2015 . ^ Leslie, Shern L. Chew, David (2006).Clinical endocrinology and diabetes ISBN 978-0443073038 {{cite book }}: CS1 maint: multiple names: authors list (link )^ Pavord, Sherif Gonem; foreword by Ian (2010).Diagnosis in acute medicine ISBN 978-184619-433-7 . Retrieved6 August 2015 . {{cite book }}: CS1 maint: multiple names: authors list (link )^ Wheeler, D.S.; Wong, H.R.; Shanley, T.P. (2014).Pediatric critical care medicine: respiratory, cardiovascular and central nervous systems ISBN 978-1-4471-6355-8 . Retrieved6 August 2015 . ^ Parker, Rolland S. (2012).Concussive brain trauma neurobehavioral impairment and maladaptation ISBN 978-1-4200-0798-5 . Retrieved6 August 2015 . ^ "Migraine Headache Clinical Presentation" .Medscape.com . eMedicine. Retrieved6 August 2015 .^ McKee, Mitchell Bebel Stargrove, Jonathan Treasure, Dwight L. (2008).Herb, nutrient, and drug interactions : clinical implications and therapeutic strategies ISBN 978-0-323-02964-3 . Retrieved6 August 2015 . {{cite book }}: CS1 maint: multiple names: authors list (link )^ Walker, W. Allan; Watkins, John B., eds. (1997).Nutrition in pediatrics: basic science and clinical applications ISBN 978-1-55009-026-0 . Retrieved6 August 2015 . ^ Schwartz, R.B.; Schwartz, R.B.; McManus, J.G.; Swienton, R.E. (2008).Tactical emergency medicine ISBN 978-0-7817-7332-4 . Retrieved6 August 2015 . ^ Vyas, JN (2008).Textbook of Postgraduate Psychiatry (2 Vols.) ISBN 978-81-7179-648-9 . Retrieved6 August 2015 . ^ "Hemochromatosis Clinical Presentation" .Medscape.com . eMedicine. Retrieved6 August 2015 .^ J. W. Bennett; M. Klich (2003)."Mycotoxins" .Clin Microbiol Rev .16 (3):497– 516.doi :10.1128/CMR.16.3.497-516.2003 .PMC 164220 PMID 12857779 . ^ 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.doi :10.1093/ndt/gfn115 ISSN 0931-0509 .PMID 18456680 . ^ "Nocturia and nocturnal polyuria in men with lower urinary tract symptoms: oral desmopressin | key-points-from-the-evidence | Advice | NICE" .www.nice.org.uk . 9 April 2013. Retrieved2015-08-03 .
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