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Polyuria

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  • 1. polyuria excessive or abnormally large production and/or passage of urine (>3 L per day in adults). Frequent urination – accompanying syndrome Diuresis – increased production and passage of urine
  • 2. Mechanisms of polyuria Due to excretion of increased nonabsorbable solutes(such as glucose) – SOLUTE DIURESIS Due to excretion of increased water(from a defect in ADH production or renal responsiveness) – WATER DIURESIS
  • 3. Water diuresis Urine output >3 L per day Urine is dilute (<250 mosmol/ L) Causes – polydipsia , central diabetes insipidus , nephrogenic diabetic insipidus
  • 4. Solute diuresis Urine output > 3 L per day Urine osmolarity > 300 msmol/L Causes – increased glucose,mannitol or urea medullary cystic diseases,obstruction,diuretics
  • 5. TYPES OF POLYURIAI. pathological polyuria Polyuria caused by a disease of the kidney or disorder anywhere in the body eg. Diabetes mellitus, diabetes insipidus,liver failure
  • 6. II. Pharmacological polyuria Polyuria caused by administerd fluids or by medication such as glucocorticoids or diuretics
  • 7. III. Physiological poyuria Compensatory mechanism to increased fluid intake Cold diuresis – in hypothermia as a result of peripheral vasoconstriction,hyperglycemia and decresed renal tubular reabsorption Altitude diuresis
  • 8. polydipsia Increase in thirst Often appear in conjugation with polyuria It can either be cause or effect of polyuria
  • 9. Psychogenic polydipsia Also called primary polydipsia Patient intakes increased amount of fluid due to sensation of having a dry mouth Most commonly due to phenothiazine medication used in mental disorders
  • 10. Diabetes insipidus Disorder that causes polyuria due to impaired urinary concentrating ability leading to increased free water clearance Polydipsia present Plasma sodium may be normal
  • 11. . Free water is the water free of solutes Free water clearance = urine flow rate – osmotic clearance Osmotic clearance = urine flow rate x urine osmolality/plasma osmolality
  • 12. Two types of DI Central DI – amount of ADH produced by the pituitary is below normal Nephrogenic DI – kidney’s ability bto respond to ADH is defective