POLYURIA

Ask the Following Questions:

1. Is it transient? Migraine, asthma, and drugs such as diuretics may produce transient polyuria.
2. Is it massive? Massive polyuria is usually due to pituitary or nephrogenic diabetes insipidus and psychogenic polydipsia. It may also be due to diabetes mellitus.
3. Is there polyphagia and polydipsia? The presence of polyphagia and polydipsia suggests the possibility of diabetes mellitus and hyperthyroidism.
4. Is the polyuria mild? The presence of a mild polyuria suggests chronic nephritis, renal tubular acidosis, hyperparathyroidism, Fanconi's syndrome, and mild diabetes mellitus.
5. Is there glycosuria? The presence of glycosuria suggests diabetes mellitus, hyperthyroidism, and Fanconi's syndrome.

DIAGNOSTIC WORKUP

Routine tests include a CBC, sedimentation rate, urinalysis, urine culture and colony count, chemistry panel, thyroid panel, and x-rays of the skull and long bones. The 24-hr intake and output should be measured. A serum and urine osmolality will be helpful, as would a spot urine sodium.

If pituitary diabetes insipidus is suspected, a CT scan of the brain and tests for pituitary hormones should be done. The intake and output before and after Pitressin® may be measured.

If renal disease is suspected, the urinary sediment should be examined microscopically and renal biopsy may be necessary. An endocrinologist and nephrologist should be consulted before undertaking expensive diagnostic tests.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

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Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

More About Causes of Frequent urination

• Back to symptom: Frequent urination: Introduction (review 148 causes)
• Next Book Extract About Frequent urination: PROTEINURIA (Algorithmic Diagnosis of Symptoms and Signs)
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More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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