Polyuria resident survival guide: Difference between revisions

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(/* Common causes {{cite journal| author=Wieliczko M, Matuszkiewicz-Rowińska J| title=[Polyuria]. | journal=Wiad Lek | year= 2013 | volume= 66 | issue= 4 | pages= 324-8 | pmid=24490488 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24490488 }} {{cite journal| author=Weiss JP, Everaert K| title=Management of Nocturia and Nocturnal Polyuria. | journal=Urology | year= 2019 | volume= 133S | issue= | pag...)
(/* Common causes {{cite journal| author=Wieliczko M, Matuszkiewicz-Rowińska J| title=[Polyuria]. | journal=Wiad Lek | year= 2013 | volume= 66 | issue= 4 | pages= 324-8 | pmid=24490488 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24490488 }} {{cite journal| author=Weiss JP, Everaert K| title=Management of Nocturia and Nocturnal Polyuria. | journal=Urology | year= 2019 | volume= 133S | issue= | pag...)
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**[[Urinary tract infection]] ([[UTI]])
**[[Urinary tract infection]] ([[UTI]])
**Hypercalcemia
**Hypercalcemia
**Benign prostatic hyperplasia (BPH)
**Stress incontinence
**Diuretics
**Overactive bladder


* '''[[Nocturnal]] [[Polyuria]]''' ([[NP]]) can be caused by different medical conditions including:
* '''[[Nocturnal]] [[Polyuria]]''' ([[NP]]) can be caused by different medical conditions including:

Revision as of 09:46, 8 September 2020

Overview

Causes

Life Threatening Causes

Common causes [3] [2]

Diagnosis

Approach to Polyuria

 
 
 
 
 
 
 
 
 
 
 
 
Suspected hypotonic polyuria[5]
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Confirm presence of polyuria:
(>50ml/kg/24hrs or >3-4L/day)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(Polyuria confirmed):
Measure urine osmolality
 
 
 
(No polyuria/ or >800 mOsm/kg):
Diabetes insipidus(DI)/Primary polydipsia ruled out
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(<800 mOsm/kg):
Hypotonic polyuria confirmed:
Measure serum Sodium and plasma osmolality
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Low normal or low serum Sodium (<150 mmol/L), plasma osmolality (<280 mOsm/kg):
Primary polydipsia
 
 
 
 
Normal serum Sodium/plasma osmolality:
Indeterminate diagnosis
 
 
 
High serum Sodium (>146 mmol/L), plasma osmolality (>300 mOsm/kg):
Central or Nephrogenic DI
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Water deprivation test
 
 
 
 
 
Baseline plasma copeptin
 
 
 
Hypertonic saline infusion test
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Urine Osm >800 mOsm/kg
 
Urine Osm <300 mOsm/kg
 
Urine Osm 300-800 mOsm/kg
 
 
 
 
 
 
Plasma coprptin >4.9pmol/L
 
Plasma coprptin <4.9pmol/L
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mild primary polyuria
 
Desmopressin administration
 
 
 
 
>21pmol/L
 
<2.6pmol/L
 
>2.6pmol/L
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(Urine Osmolality: 300-800 mOsm/Kg and <50% increase):
Therapeutic trial with desmopressin
 
Nephrogenic DI(partial or complete)
 
Complete Central DI
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Primary polydipsia
 
Partial Nephrogenic DI
 
Partial Central DI
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(Initial urine osmolality: 30 mOsm/kg and >50% increase after desmopressin):
Complete Central DI
 
(Urine osmolality <300 mOsm/kg or <50% increase):
Complete Nephrogenic DI
 
 
 
 
 
 
 

Do's

Don'ts

References

  1. Moore K, Thompson C, Trainer P (2003). "Disorders of water balance". Clin Med (Lond). 3 (1): 28–33. doi:10.7861/clinmedicine.3-1-28. PMC 4953350. PMID 12617410.
  2. 2.0 2.1 Weiss JP, Everaert K (2019). "Management of Nocturia and Nocturnal Polyuria". Urology. 133S: 24–33. doi:10.1016/j.urology.2019.09.022. PMID 31586470.
  3. Wieliczko M, Matuszkiewicz-Rowińska J (2013). "[Polyuria]". Wiad Lek. 66 (4): 324–8. PMID 24490488.
  4. Nigro N, Grossmann M, Chiang C, Inder WJ (2018). "Polyuria-polydipsia syndrome: a diagnostic challenge". Intern Med J. 48 (3): 244–253. doi:10.1111/imj.13627. PMID 28967192.
  5. Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dungan K; et al. (2000). "Endotext". PMID 30779536.