Polyuria: Difference between revisions
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==Background== | ==Background== | ||
*Excessive urine volume | |||
**Distinguish from urinary frequency, which may not produce high ''volumes'' of urine | |||
==Clinical Features== | ==Clinical Features== | ||
*3 L/day of urine in adults and 2 L/m2 in children | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
===[[Polyuria]]=== | |||
*Osmotic diuresis | |||
**[[Hyperglycemia]] | |||
**[[Mannitol]] | |||
*Drugs: [[diuretics]], [[caffeine]], [[acetazolamide]], [[lithium]] | |||
*[[Hypercalcemia]] | |||
*[[Hypokalemia]] | |||
*[[Diabetes insipidus]] | |||
*[[Cushing's syndrome]], primary hyperaldosteronism | |||
*Inability to concentrate urine (e.g. chronic [[pyelonephritis]], [[sickle cell disease]], [[amyloidosis]] | |||
*[[Post-obstructive diuresis]] | |||
*Early [[renal failure]] | |||
*High fluid intake | |||
**Excess [[IVF]] | |||
**Psychogenic polydipsia | |||
==Evaluation== | ==Evaluation== | ||
[[File:Polyuria algorithm.png|thumb|]] | |||
*Evaluate for [[dehydration]] | |||
*BMP | |||
*UA | |||
*Additional workup depending on history | |||
*Consider: | |||
**Urine osmolality, electrolytes | |||
**Serum osmolality | |||
**Serum ADH | |||
**Renal imaging | |||
==Management== | ==Management== | ||
*Correct [[electrolyte abnormalities]], [[dehydration]] | |||
*Treat underlying pathology if known | |||
==Disposition== | ==Disposition== | ||
*Dependant on presentation/severity | |||
==See Also== | ==See Also== | ||
Latest revision as of 16:02, 18 August 2019
Background
- Excessive urine volume
- Distinguish from urinary frequency, which may not produce high volumes of urine
Clinical Features
- 3 L/day of urine in adults and 2 L/m2 in children
Differential Diagnosis
Polyuria
- Osmotic diuresis
- Drugs: diuretics, caffeine, acetazolamide, lithium
- Hypercalcemia
- Hypokalemia
- Diabetes insipidus
- Cushing's syndrome, primary hyperaldosteronism
- Inability to concentrate urine (e.g. chronic pyelonephritis, sickle cell disease, amyloidosis
- Post-obstructive diuresis
- Early renal failure
- High fluid intake
- Excess IVF
- Psychogenic polydipsia
Evaluation
- Evaluate for dehydration
- BMP
- UA
- Additional workup depending on history
- Consider:
- Urine osmolality, electrolytes
- Serum osmolality
- Serum ADH
- Renal imaging
Management
- Correct electrolyte abnormalities, dehydration
- Treat underlying pathology if known
Disposition
- Dependant on presentation/severity