Polyuria
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
- 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
- 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
See Also
External Links
References
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