Polyuria R35

Increased daily amount of urine.

The daily urine volume is > 2000 ml/day (other sources give figures of > 3000 ml/day). At the same time there is polydipsia (pathologically increased thirst).

Occurs at any age without gender preference.

In addition to the usual laboratory parameters, determination should be carried out in any case if the genesis is unclear:

• blood sugar

• Creatinine

• GFR

• Electrolytes

• Urine - or serum osmolality

• ADH in the sense of ADH, if applicable

• possibly aldosterone

• NT-proBNP (the value correlates inversely with kidney function)

• Urine sediment

Polyuria is a symptom of a disease. It can have prerenal, renal or postrenal causes.

Polyuria occurs in:

• diabetes insipidus (urine volume is 5 - 25 l/d)

• psychogenic polydipsia (history; psychiatric disease known?)

• diabetes mellitus

• partial urinary tract obstruction or urinary retention

• hyperaldosteronism

• Hypercalcaemia (most frequent cause is malignancy)

• hypokalemia

• in the early stages of acute renal failure (in 30 %)

• chronic renal insufficiency

• cardiac insufficiency (here usually as nocturia)

• certain medications (e.g. diuretics, clonidine, cortisone, mannitoline infusions, X-ray contrast media)

• excessive alcohol consumption (alcohol inhibits ADH)

• plasmocytoma

• Sarcoidosis

• Bartter syndrome

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2. Braun J et al (2009) Clinical Guide to Internal Medicine S 390-393
3. Gerok W et al (2007) Internal Medicine 772
4. Hautmann R et al (2014) Urology 26-27
5. Herold G et al (2018) Internal Medicine S 209, 600, 635, 656, 783, 803-804
6. Jakes AD et al (2014) Investigating polyuria. BMJ 103: 597-601
7. Siegenthaler W et al (2001) Clinical pathophysiology S 261