Polyuria

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Not to be confused with polyurea.
Polyuria
ADH3.svg
Regulation of urine production by ADH and aldosterone
Specialty Endocrinology, nephrology
ICD-10 R35
ICD-9 788.42
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]

Causes[edit]

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.[medical citation needed]

List of causes[edit]

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

Mechanism[edit]

Polyuria in osmotic cases, increases flow amount in the distal nephron where flow rates and velocity are low.The significant pressure increase occuring 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[edit]

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[edit]

References[edit]

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  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. 
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  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. doi:10.1093/ndt/gfn115. ISSN 0931-0509. PMID 18456680. 
  37. ^ Merseburger, Axel S.; Kuczyk, Markus A.; Moul, Judd W. (2014-10-21). Urology at a Glance. Springer. ISBN 9783642548598. 
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Further reading[edit]