Polyuria Differential Diagnosis Table

The condition of the body where the body starts to urinate more than usual and abnormally much in a day with the large volume of urine, even more than 3 liters in a day, known as polyuria. In adults, normal urine output is usually 1 to 2 liters per day.

Usually, Polyuria is caused by drinking the large amount of water and caffeine or alcohol. Large of excreation of urine is also the sign of diabeties and that’s the reason mostly the diabetic patients experinced this condition and polyuria is also somehow associated with the diabetes.

The problem of excessive urination is the problem that can be solved and treated at home and it is quite easy to follow a few instructions from your doctor. This is entirely possible and has a huge impact simply by making lifestyle changes. Understanding the side effects of the drug and reducing or stopping alcohol consumption have a major impact on polyuria.

Sometimes it is graceful to talk about this problem of excessive urination, but you must stop being shy in front of a doctor so that a doctor can perform the various tests to identify the true cause of the problem and prescribe the medication.

Polyuria Differential Diagnosis Table:

The term Polyuria is used to refer to increased urine production. This increase in urine production has to be equivalent to more than 3L of urine in 24 hours for an adult and 2.5L for pediatric patients. There are several terms that can be confused with Polyuria, and it is important to keep in mind, Pollakiuria, which is urinating several times during the day but the urine output does not exceed 3L of urine in 24 hours. There is also the term Nocturia, which consists of interrupting sleep to urinate. These terms can also coexist. It is important to know what determines the amount of urine produced in 24 hours, which is dependent on three important factors:
Intake: Which is the amount of liquid we drink during the day.
Disposal of substances: Remember that urine is a mechanism of the body to dispose of metabolites among other substances that the body does not need.
Renal functioning: Remember that urine is produced by the kidneys, which means that it depends on the kidneys how it works or how it functions.

Among the causes of Polyuria are even routines in our daily life that could lead to this symptom. Among the general causes are:
Increased fluid intake: Obviously increased fluid intake increases urine, but in this case, it would be a temporary and relative Polyuria since simply decreasing fluid intake would be temporary without any complications.
Increased salt consumption: Salt is a substance that carries water, so if the patient eats very salty food, it will carry water to the kidneys to expel that urine, which is also a benign Polyuria.
Consumption of stimulant beverages: There are some beverages that increase the volume or production of urine such as caffeine or tea.
Use of diuretics: There are drugs used for various diseases that have the adverse effect of Polyuria.

Presentation Of Polyuria In Different Diseases

How to Recognize that Diabetes Mellitus is Causing Polyuria

Polyuria is the response to high blood sugar glucose. Blood glucose is so high that the only way to eliminate it is through excretion by significantly increasing urine volume. As Polyuria occurs in different diseases, the way to recognize if the cause is Diabetes Mellitus is through a good medical history, searching for family history, as well as the presence of the triad of Diabetes in which Polyuria is also accompanied by Polydipsia and Polyphagia. Adding to this, laboratory tests such as glycosylated hemoglobin and glucose tolerance curves confirm the diagnosis.

How to Recognize that Chronic Kidney Disease is Causing Polyuria

In Chronic Kidney Disease, the kidneys are not able to perform one of their main functions, which is to filter the blood properly for the proper production of urine. Therefore, because of this malfunction to filter, certain substances necessary for the proper functioning of the body, such as proteins and albumin, are also filtered, which will be evidenced by a urine test. There will also be frothy urine.

How to Recognize that Hyperthyroidism is Causing Polyuria

Hyperthyroidism is an endocrine disorder that produces thyrotoxicosis, which translates as sweating and heat intolerance, stimulating thirst, causing increased natriuretic peptides secreting sodium which in turn drags water, eventually causing Polyuria. The diagnosis will be confirmed with thyroid hormone labs in addition to symptoms of prominence and physical signs such as proptosis.

How to Recognize that Cushing’s Syndrome is Causing Polyuria

In this disease, there is an excess of the hormone cortisol, which has among its functions to help balance the water and sodium in the body, causing Polyuria accompanied by physical characteristics such as a buffalo hump between shoulders, central obesity, moon face, acne, extreme fatigue or muscle weakness, psychiatric disorders such as depression, anxiety, and complications such as hypertension and recurrent infections.

How to Recognize that Hypercalcemia is Causing Polyuria

Hypercalcemia causes a decrease in urine concentration in the distal tubule, increasing renal losses of sodium and water exponentially. Hypercalcemia is an extremely dangerous condition since it presents changes in the central and peripheral nervous systems, in the gastrointestinal tract, as well as cardiovascular symptoms, which are changes in the T segment and in the QT interval. It can also cause calcium crystals, producing lithiasis.

How to Recognize that Diabetes Insipidus is Causing Polyuria

In Diabetes Insipidus, dilute urine is produced because the renal tubules are not able to respond to the antidiuretic hormone and it is not possible to reabsorb the water back into the body. In this disease, Polyuria is present, but it is extremely dilute, without the presence of hyperglycemia, hence the name.

Common Red Flags With Polyuria

If you are presenting Polyuria for any of the most common general causes already mentioned, there is no need to pay so much attention to this, but if it is already in a more persistent form and in the absence of these causes, the idea would be to visit a family doctor, since Polyuria may be the only symptom that presents itself in silent diseases such as Hypertension. The most common cause of sudden Polyuria is Central Diabetes Insipidus. The most common causes of Chronic Polyuria are Nephrogenic and Central Diabetes Insipidus. There are four diseases in which we should think of a patient with persistent, non-momentary, and non-benign Polyuria: Arterial Hypertension, Diabetes, Cardiac, and Renal Insufficiency.

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