Polyuria () is excessive or an abnormally large production or

passage Passage, The Passage or Le Passage may refer to: Arts and entertainment Films * ''Passage'' (2008 film), a documentary about Arctic explorers * ''Passage'' (2009 film), a short movie about three sisters * ''The Passage'' (1979 film), starring ...

urine Urine is a liquid by-product of metabolism in humans and in many other animals. Urine flows from the kidneys through the ureters to the urinary bladder. Urination results in urine being excreted from the body through the urethra. Cellular ...

(greater than 2.5 L or 3 L over 24 hours in adults). Increased production and passage of urine may also be termed diuresis. Polyuria often appears in conjunction with

polydipsia Polydipsia is excessive thirst or excess drinking.Porth, C. M. (1990). ''Pathophysiology: Concepts of altered health states''. Philadelphia: J.B. Lippincott Company. The word derives from the Greek () "very thirsty", which is derived from (, "mu ...

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

Primary polydipsia Primary polydipsia and psychogenic polydipsia are forms of polydipsia characterised by excessive fluid intake in the absence of physiological stimuli to drink. Psychogenic polydipsia which is caused by psychiatric disorders, often schizophrenia, i ...

may lead to polyuria. Polyuria is usually viewed as a symptom or sign of another

disorder Disorder may refer to randomness, non-order, or no intelligible pattern. Disorder may also refer to: Healthcare * Disorder (medicine), a functional abnormality or disturbance * Mental disorder or psychological disorder, a psychological pattern ...

(not a disease by itself), but it can be classed as a disorder, at least when its underlying causes are not clear.

Causes

The most common cause of polyuria in both adults and children is uncontrolled

diabetes mellitus Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...

, which causes osmotic diuresis, when glucose levels are so high that glucose is excreted in the urine. Water follows the glucose concentration passively, leading to abnormally high urine output. In the absence of diabetes mellitus, the most common causes are decreased secretion of aldosterone due to adrenal cortical tumor,

primary polydipsia Primary polydipsia and psychogenic polydipsia are forms of polydipsia characterised by excessive fluid intake in the absence of physiological stimuli to drink. Psychogenic polydipsia which is caused by psychiatric disorders, often schizophrenia, i ...

(excessive fluid

drinking Drinking is the act of ingesting water or other liquids into the body through the mouth, proboscis, or elsewhere. Humans drink by swallowing, completed by peristalsis in the esophagus. The physiological processes of drinking vary widely am ...

central diabetes insipidus Central diabetes insipidus, also called neurogenic diabetes insipidus, is a type of diabetes insipidus due to a lack of vasopressin (ADH) production in the brain. Vasopressin acts to increase the volume of blood (intravascularly), and decrease ...

and

nephrogenic diabetes insipidus Nephrogenic diabetes insipidus, also known as renal diabetes insipidus, is a form of diabetes insipidus primarily due to pathology of the kidney. This is in contrast to central or neurogenic diabetes insipidus, which is caused by insufficient le ...

. Polyuria may also be due to various chemical substances, such as diuretics,

caffeine Caffeine is a central nervous system (CNS) stimulant of the methylxanthine class. It is mainly used recreationally as a cognitive enhancer, increasing alertness and attentional performance. Caffeine acts by blocking binding of adenosine to ...

, and

ethanol Ethanol (abbr. EtOH; also called ethyl alcohol, grain alcohol, drinking alcohol, or simply alcohol) is an organic compound. It is an alcohol with the chemical formula . Its formula can be also written as or (an ethyl group linked to a ...

. It may also occur after supraventricular tachycardias, during an onset of atrial fibrillation,

childbirth Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births glob ...

, and the removal of an obstruction within the

urinary tract The urinary system, also known as the urinary tract or renal system, consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pressure, c ...

. Diuresis is controlled by antidiuretics such as

vasopressin Human vasopressin, also called antidiuretic hormone (ADH), arginine vasopressin (AVP) or argipressin, is a hormone synthesized from the AVP gene as a peptide prohormone in neurons in the hypothalamus, and is converted to AVP. It then trave ...

, angiotensin II and aldosterone. ''Cold diuresis'' is the occurrence of increased urine production on exposure to cold, which also partially explains

immersion diuresis Diuresis () is increased urination (polyuria) or, in the related word senses more often intended, the physiological process that produces such an increase or the administration of medications to encourage that process. It involves extra urine pro ...

. ''High-altitude diuresis'' occurs at altitudes above and is a desirable indicator of adaptation to high altitudes. Mountaineers who are adapting well to high altitudes experience this type of diuresis. Persons who produce less urine even in the presence of adequate fluid intake are probably not adapting well to altitude. Bacteriuria pyuria 4

List of causes

Mechanism

Polyuria in osmotic cases, increases flow amount in the distal nephron where flow rates and velocity are low. The significant pressure increase occurring in the distal nephron takes place particularly in the cortical-collecting ducts. One study from 2008 lays out a hypothesis that hyperglycaemic and osmotic polyuria play roles ultimately in diabetic nephropathy.

Diagnosis

Among the possible tests to diagnose polyuria are:

Treatment

Depending on the cause of the polyuria, the adequate treatment should be afforded. According to

NICE Nice ( , ; Niçard dialect, Niçard: , classical norm, or , nonstandard, ; it, Nizza ; lij, Nissa; grc, Νίκαια; la, Nicaea) is the prefecture of the Alpes-Maritimes departments of France, department in France. The Nice urban unit, agg ...

, desmopressin can be considered for nocturnal polyuria, which can be caused by diabetes mellitus, if other medical treatments have failed. The recommendation had no studies that met the criteria for consideration.

References

External links

{{Urinary system symptoms and signs Symptoms and signs: Urinary system