This book describes Polyuria (Frequent Urination), Diagnosis and Treatment and Related Diseases

Are you one of the millions of people who pass copious amount of urine every day and worse still at night?

Polyuria is also called excessive or frequent urination of copious amount of urine.

Polyuria happens when one urinates more than what would be considered normal.

Urinary volume should not be more than 2.5 liters daily thus anything larger than this volume is considered excessive.

Polyuria is the passing of abnormally large volumes of urine, which equals to more than 2.5 liters of urine per day or urine output more than 40 ml/kg/day.

Polyuria manifests much less often than urinary frequency.

Polyuria is often followed by higher frequency of urination, but the two disorders are not always related since the underlying cause is normally different.

Frequent passage of large amounts of urine will lead to polyuria.

Frequent passage of small amounts of urine indicates a totally different disorder.

It is very important to evaluate the frequency of urination and the volumes of urine passed.

Higher production and passage of urine may also be termed diuresis.

Polyuria often appears together with polydipsia (increased thirst), though it is possible to have one without the other, and the latter may be a cause or an effect.

The causes of polyuria are normally also the causes of polydipsia.

Primary polydipsia may lead to polyuria.

Polyuria is normally regarded as a symptom or sign of another disorder (not a disease by itself), but it can be classified as a disorder, at least when its underlying causes are not known.

There are 5 main causes of polyuria:

Renal

1. Nephrogenic Diabetes Insipidus:


2. Fanconi's Syndrome:


3. Early Chronic Pyelonephritis:


4. Chronic Kidney Disease (CKD):


5. Other kidney diseases can affect kidney function such as:
   
   a. Interstitial cystitis
   
   b. Urinary tract infection
   
   c. Renal tubular acidosis
   
   d. Nephronophthisis (genetic)

Endocrine

1. Diabetes Mellitus: Uncontrolled diabetes mellitus can induce polyuria due to osmotic diuresis.


2. Central Diabetes Insipidus: Diabetes insipidus presents as excessive excretion of water in the urine.


3. Cushing's Syndrome: Frequent urination is a symptom of Cushing's syndrome which can happen due to pituitary gland tumor and ectopic adrenocorticotropic hormone (ACTH)-secreting tumor


4. Other endocrine Diseases can also cause polyuria:
   
   a. Hyperparathyroidism
   
   b. Hyperthyroidism
   
   c. Hypopituitarism
   
   d. Conn's disease

Iatrogenic

1. Diuretic therapy:
   
   Polyuria can happen due to recent usage of diuretics for excreting excess water in the body


2. Alcohol:
   
   Drinking too much alcohol can induce polyuria.


3. Lithium:
   
   A patient having a history of lithium use for treating bipolar disorder and mental diseases can show symptoms of polyuria.


4. Tetracycline:
   
   Polyuria is a possible adverse side-effect of antibiotics like tetracycline.


5. Other Causes
   
   a. High doses of riboflavin (vitamin B2)
   
   b. High doses of vitamin D

Metabolic

1. Hyper-calcemia:
   
   This is the rise in blood levels of calcium.


2. Hypokalemia:
   
   In this disorder, the blood concentration of potassium drops.

Psychological

1. Polyuria can happen due to excessive compulsive drinking of water.
   
   This can be caused by anxiety or a history of psychiatric illness.


2. Polyuria is an infrequent but serious complication of psychotic illness and, if untreated, may lead to hyponatremia, coma or even death.

Basically a high urine flow rate may be produced either by a primary increase in:

1. solute excretion or


2. water excretion

This causes polyuria.

TABLE OF CONTENT

Introduction

Chapter 1 Polyuria (Frequent Urination)

Chapter 2 Causes

Chapter 3 Symptoms

Chapter 4 Diagnosis

Chapter 5 Treatment

Chapter 6 Prognosis

Chapter 7 Overactive Bladder

Chapter 8 Urinary Incontinence

Chapter 9 Benign Prostate Hypertrophy

Epilogue