Polyuria
| Classification according to ICD-10 | |
|---|---|
| R35 | Polyuria |
| ICD-10 online (WHO version 2019) | |
The polyuria (from Greek πολυουρία poliuría , German , “a lot of urination” ) is the medical name for a pathologically increased urine excretion (increased diuresis ). In adults, this is the case with a urine volume of significantly more than 2 liters in 24 hours (normally 0.8 to 1.5 liters per day).
causes
- Diabetes mellitus : In the case of poorly controlled or possibly undetected diabetes mellitus, a so-called osmotic diuresis (filtration diuresis ) leads to polyuria with excretion of glucose ( glucosuria )
- Polyuric phase after acute kidney failure
- Renal and (formerly also called pituitary-diencephalic polyuria) central diabetes insipidus (water diuresis)
- Medication ( diuretics )
- Alcohol (centrally inhibits the release of ADH )
- possibly with chronic renal insufficiency with isosthenuria
- Nocturia (nocturnal polyuria) in heart failure ( edema washout)
- Bartter syndrome
- Conn syndrome
Symptoms
As a rule, in addition to the increased urine excretion (more than 2 l in 24 hours), there is also an urgent increase in thirst ( polydipsia ) to compensate for the loss of fluid. Often, however, a so-called desiccosis (dehydration) is found.
Diagnosis
- Look for the underlying conditions mentioned above
- Blood sugar
- Electrolytes : It is important to control the electrolytes, as polyuria can lead to loss of blood pressure. a. of sodium , potassium and calcium may
- Medical history and alcohol history
- Hematocrit
- Creatinine
- Urine and blood osmolarity
Differential diagnosis
In psychogenic polydipsia , patients drink too much because of a mental illness. Of course, the amount of urine is secondarily increased. In pollakiuria , the urination frequency is increased without changing the total amount of urine.
Older literature
- Joachim Frey : Changes in urine volume. In: Ludwig Heilmeyer (ed.): Textbook of internal medicine. Springer-Verlag, Berlin a. a. 1955; 2nd edition, ibid. 1961, pp. 905-910, and pituitary-diencephalic poly- and oliguria : pp. 917-919.
