Polyuria is not considered a disease, but it is one of the signs of various diseases. In the Latin translation – it is a pathological condition which is accompanied by the abundant excretion of urine. Causes of polyuria doctor need to find out for appointments optimal therapy.
In quantitative terms, the daily diuresis exceeds the upper limit of normal (1800-2000 ml with normal drinking regime) and in severe cases, comes to 3000. Some confuse polyuria with frequent urination. This symptom may be accompanied, but it is always accompanied by frequent urination in the toilet and urine in small portions so that this condition does not affect the daily urine.
How is the fluid in the body?
For a healthy adult per day in output 1000-1500 ml of urine. Found that ¾ of fluid the body secretes through the kidneys, ¼ – via the skin, intestine, and lung tissue.
The total amount of daily urine (diuresis) depends on the right balance between:
- the glomerular filtration;
- the reabsorption of water in tubules.
Physiological mechanisms of adaptation of the water balance are triggered mainly by the processes of reabsorption, simultaneously, the concentration of dissolved substances.
Dehydration (fluid loss) occurs when:
- sweating in the heat, when febrile diseases;
- vomiting, prolonged diarrhea (especially in children);
- the build-up of edema in the legs, feet, abdomen, face (rarely observed with a significant accumulation of fluid in the cavities of the pleura, heart bags);
- overdose of diuretics and herbal teas.
The appearance of thirst in a healthy person indicates the beginning of dehydration
The body reacts to the connection processes of antidiuresis: the effects of antidiuretic hormone decreases the permeability of the tubular epithelium to water, stands a highly concentrated urine, but in small quantity.
The opposite state of hyperhydration (excessive flood) after the reception:
- a significant volume of liquid (water, beer);
- lots of fruits and vegetables.
- abuse of coffee;
- neurosis and neurasthenia in the climacteric period in women.
Accompanied by a deficiency of antidiuretic hormone, increased secretion of water through tubules, the final urine has a weak concentration. It is this process that is disrupted in pathological polyuria, which will be further discussed. Physiological polyuria occurs temporarily, disappears after compensation of water-electrolyte disorders by the body.
The mechanism of
Pathological polyuria is observed in the failure mechanisms of adaptation. In clinical practice it is known the combination with polydipsia (severe thirst). It is caused by hormonal changes and is manifested by increased fluid intake. Syndrome is considered politologichni is called as “polyuria-polydipsia”.
The origin of the enhanced diuresis divided conditionally on: kidney (renal) and extrarenal (extrarenal). Renal – the main causes are directly in the kidney, observed:
- in congenital and acquired pathological changes in the tubules;
- in the initial stage CRF (chronic renal failure);
- in the period of recovery in acute renal failure.
Accompanied by some urological diseases complicated by impaired renal function:
- chronic pyelonephritis;
- distal tubular acidosis;
- benign prostatic hyperplasia in men.
Extrarenally – induced impairment of the General circulation, neuroendocrine regulation of urine formation, disorder of the urinary tract.
Varieties of polyuria and diuresis
The most frequently polyuria divide:
- temporary – for example, after a hypertensive crisis;
- continuous – formed kidney disease and endocrine glands.
There are several types of increased diuresis. Water – excreted urine concentration is low (Hypo) due to a lack of antidiuretic hormone, reducing the permeability of the tubules and collecting tubes, the ratio of dissolved substances in the urine to their content in the blood plasma of at least one.
In healthy people possible:
- when consuming a significant amount of liquid;
- the transition from active life on strict bed rest.
The astronauts for the first time in the state of weightlessness density of urine low
Polyuria with a low concentration in urine is determined by:
- with hypertensive crisis;
- after an attack of paroxysmal tachycardia;
- in the terminal phase of renal failure;
- in the treatment of heart failure in the convergence of edema;
- renal diabetes insipidus;
- chronic alcoholism;
- polydipsia after suffering encephalitis, trauma.
Osmotic – released a lot of urine due to the simultaneous loss of active substances (endogenous – glucose, urea, salts, bicarbonates, and the exogenous Mannitol, sugar). A significant accumulation of these compounds impairs the ability of tubules for reabsorption, they begin to pass water in the final urine. The result is a large volume of liquid with a high concentration of active substances.
Polyuria with high specific gravity of urine is characteristic for the expressed metabolic disorders, detected in diseases such as:
- diabetes mellitus;
- the syndrome Itsenko-Kushinga;
- tumors of the adrenal cortex;
- multiple myeloma;
The same change causes an overdose of osmotic diuretics.
Nocturnal polyuria is called this symptom is nocturia. This condition also applies to violations of diuresis. When most of the urine is in the daytime and in the nighttime.
Under normal conditions, the ratio of day and night urine volume is 4:1 or 3:1
The reasons it is often necessary to search in hidden edema in renal or heart failure. In the daytime people often is in a vertical position, it creates an increase in hydrostatic pressure in veins of the lower extremities. Therefore, the liquid is deposited in tissues and creates swelling in the feet and legs. The process is accompanied by a reduction in the volume of circulating plasma, urine output decreases compensatory reasons.
At night, the condition is reversed.
Nocturia origin can be:
- the Central character (accompanied by a neuroses, diencephalic disorders);
- or is part of the symptom complex of a variety of urological diseases (prostatitis, prostate adenoma).
In pregnant women, nocturia is regarded as a physiological process. But this does not mean total denial of a possibility of development of this symptom polyuria in diabetes mellitus with decompensated. Therefore, if pregnancy occurs on the background of endocrine pathology, control of diuresis has diagnostic value.
The symptoms of polyuria
Clinical manifestations polyuria are:
- frequent urination with copious urine;
- lowering blood pressure;
- “darkening” in the eyes;
- dry mouth;
Long polyuria in kidney disease leads to the appearance of cracks on the skin, mucous membranes. Symptoms are caused by dehydration and loss of essential electrolytes.
The development of chronic renal failure is accompanied by a change of the stages of oliguria and anuria (decreased urine allocation until the end) with a high specific gravity of urine in violation of the inverse process of absorption of necessary substances from the primary urine. Severe leads to a complete loss of the ability of tubules for reabsorption of water.
For kidney disease is characterized by:
- pain syndrome – pain may have a different intensity (from attacks of renal colic before arching dull) with localization in the lower back, one side of the abdomen, above the pubes, radiating to groin and genitals;
- possible cramps when urinating, if you join the inflammation of the urethra;
- temperature rise;
- urinary incontinence;
- swelling of the face in the morning;
- muscle weakness;
- shortness of breath;
- pain in region of heart;
- nausea, vomiting in the morning;
- loose stools, tendency to intestinal bleeding;
- aching pain in the bones.
In men with enlarged prostate, possible erectile dysfunction, difficulties in intimate life.
With endocrine pathology acromegaly, tumors of the adrenal gland may be accompanied by:
- the polyphagia – constant hunger, voracity;
- the proportions of the body;
- development in women body hair growth in male pattern.
When there is polyuria in children?
Polyuria in children is rare. Kidney kids is not able to filter large amount of liquid. Therefore, children are very sensitive to both flooding and dehydration of the body.
For a correct evaluation of a symptom should compare the daily urine output with normal specific age of the child
Maximum values in urine output in children is shown in table
|The age of the child
||Max urine output in ml
In young children causes the pathological condition should be distinguished from habits to attract attention by going to the toilet, uncontrolled drinking regime.
If there is a constant polyuria in the survey should be deleted:
- renal pathology;
- hidden decompensation in heart disease;
- different types of diabetes;
- mental disorders;
- the horse syndrome – tumor of the adrenal glands with increased production of aldosterone;
- disease Fanconi is an inherited gene mutation responsible for the tubular epithelium for reabsorption of essential substances and water, manifested additional symptoms such as rickets, delayed physical development.
What examination is necessary the polyuria?
To exclude renal disease is prescribed:
- urine analysis with sediment microscopy;
- biochemical tests of blood residual nitrogen, proteins, electrolytes, alkaline phosphatase;
- blood clotting;
- Abdominal ultrasound and kidneys;
- contrast urography;
- if necessary, conducted CT and MRI, kidney biopsy, examination of the vessels.
Laboratory urine test will show the increase in the share of patients with diabetes by providing glucose, low density of the urine in diseases of the kidneys, the stage of decompensation.
Endocrine pathology diagnosed through:
- analysis on blood sugar, hormones;
- the sugar curve;
- electrolyte composition of blood;
- x-rays of the bones;
- Thyroid ultrasound;
- pneumoloading x-ray studies of the adrenal glands;
- picture Turcica for detection of increase in the pituitary gland.
Methods of treatment
To normalize the diuresis it is necessary to treat the disease is detected.
Be sure the patient is recommended diet with restriction:
- salt and spicy seasonings;
- fried and canned foods;
- coffee, chocolate;
- alcohol and carbonated drinks.
Diabetes not recommended for all light carbohydrates and sugar, restrict fats.
Staying hydrated requires the addition in the treatment of polyuria:
- liquid solution of electrolytes (sodium, potassium, calcium, chloride);
- removal of intoxication;
- normalize the acid-alkaline balance of the blood.
With heart disease used cardiac glycosides, diuretics move on tiazidove series (Cyclopenthiazide, Navidrex). They are able to reduce the content of sodium in the body and reduce the amount of extracellular fluid. The faster water is absorbed, the patient gets better. Endocrine diseases are treated with drugs, substitute of missing hormones. The detection of tumor growth discusses the question of surgical treatment.
When anise seeds ripen, they are recommended crushed, and brewed as tea
The advice of traditional medicine should be used with caution, because polyuria refers to politologichni symptoms. Recommendations may be contraindicated for one disease and are suitable for the other. Most useful in the medical manual are the decoctions, extracts from anise fruits, seeds and leaves of the plantain.
The important thing to effectively combat polyuria – determining the cause of the disease. A survey in the state to establish mechanisms for violations. Therefore, the doctor can choose the most appropriate therapy.