Chapter 11 Presentation Glycosuria, Polyuria, and Polydipsia By Laura Garcia
Glycosuria Glycosuria refers to sugar in the urine. Less than 0.1% of glucose normally filtered by the glomeruli appears in the urine, and less than 130 mg should appear in the urine over a 24-hour period. Occasionally, glycosuria may be a normal finding, such as after eating a heavy meal or during times of emotional stress. Some individuals have a benign condition in which they have a lower than usual renal threshold for glucose, but have normal blood glucose levels. In pregnancy, the renal threshold for glucose may be lowered so that small amounts of glycosuria may be present. The most common reason for glycosuria is diabetes mellitus.
Diseases That can cause Glycosuria Diabetes mellitus Pregnancy High sugar diet Following a gastrectomy Hyperthyroidism Liver disease Raised intracranial pressure Liver disease Diabetes mellitus type 2 Glucose-galactosemalabsorption Hyperglycaemia Nephropathic early-onsecystinosis Pregnancy Proximal renal tubular acidosis Renal glycosuria Shwachman-Diamond syndrome Subarachnoid haemorrhag
Testing: Urine glucose tests are used to screen for diabetes, to confirm a diagnosis of diabetes, or to monitor diabetic control. Treating: Glycosuria alone is not necessarily a serious condition. Treatment is not usually necessary, although the underlying cause may requir.e therapy
Polyuria Polyuria refers to the production of abnormally large amounts (more than 2.5 litres per day for adults) of urine. Normal urine production in an adult is 1 to 2 litres. Urine volume is influenced by factors such as fluid intake, blood pressure, dietary habits, temperature, medications, mental state and general health. As people age, their kidneys become less effective and urinary symptoms become more common. Polyuria is a fairly common symptom which is often noticed when it occurs at night. Polyuria is often accompanied by excessive fluid intake (polydipsia).
Symptoms: Too much fluid intake, particularly fluids containing caffeine or alcohol. Too much salt or glucose (if diabetic). Drug use, especially diuretics. Diabetes (both diabetes insipidus and diabetes mellitus). Psychogenic polydipsia, most common in women over age 30. Renal failure. Radiographic tests that use a contrast media (urine volume will increase for up to 24 hours following the dose).
Diagnosing Tests to investigate the cause of the polyuria, which may include: Urinalysis (analysis of the urine): for diabetes (looking for glucose, ketones) and signs of renal disease. Urine culture (testing for infections). Blood glucose levels. Blood electrolyte balance (test for renal function). 24 hour urine volume. Fluid deprivation test (the intake of fluids is restricted to see if the urine volume decreases). Further specialist investigations may be needed, such as renal ultrasound or biopsy, if the cause is not clear.
Polydipsia excessive thirst. It is characteristic of several different conditions, including diabetes mellitus, in which an excessive concentration of glucose in the blood osmotically pulls intracellular fluid into the bloodstream and increases the excretion of fluid by increased urination, which leads to hypovolemia and thirst.
Cause fever burns stress sepsis anxiety polyuria diarrhea vomiting diabetes cirrohsis dry mouth liver failure hot flashes dehydration heart failure kidney failure gastroenteritis hypercalcemia eating disorder hot, dry climate juvenile diabetes severe infections high blood sugar profuse sweating frequent urination sickle cell anemia diabetes insipidus Fanconi syndrome excessive bleeding salty or spicy meal type 1 & 2 diabetes hyperparathyroidism dengue shock syndrome not drinking enough water growth hormone deficiency excessive loss of water & salt hyperaldosteronism