1. What is Polyuria ?

  • Excessive urinary production more than 3 liters per day is known as polyuria
  • The urinary production is usually 15 liters per day
  • It can be differentiated from other conditions where  the urine production is less but the frequency to go is more in cases such as benign prostatic hyperplasia or prostate enlargement ,overactive bladder or due to (UTI’s) urinary tract infections
  • Where as in polyuria both the urine production and urgency to go is more often 
  • Polyuria is rather a sign than a disease or condition usually encountered in people with diabetes mellitus or  Diabetes insipidus(uncontrolled) /Diuretics
  • The nocturnal polyuria i;e more urine at night ,can happen as a result of excessive intake of fluids at nights , congestive heart failure ,obstructive sleep apnea ,peripheral edema 

2. What are the Symptoms and Signs of Polyuria?

  • The two common symptoms of polyuria is nocturia which means urination at nights and polydipsia which means excessive thirst due to loss of fluid 
  • Apart from Polydipsia and nocturia other symptoms which are secondary to diabetes includes polyphagia,Fatigue weight loss ,headache ,malaise ,dizziness ,delayed wound healing,shortness of breath,nausea,skin allergies etc  

3. What are the causes of Polyuria?

The most common cause of polyuria is diabetes mellitus where the blood sugar levels are extremely high due to improper filtering of blood glucose resulting in elimination of larger amounts of glucose in urine 

The other causes include 

  • Kidney disease(Chronic kidney disease) /a renal failure is an earliest sign or a  reason for polyuria
  • Diabetes insipidus happens as a result of compromised kidney health or due to any head surgeries /infection or tumor in and around the area which further can lead to uncontrolled fluid balance resulting ultimately with Polydipsia and polyuria 
  • Medications especially  Diuretics,calcium channel blockers, Tetracycline,lithium ,Selective serotonin reuptake inhibitors or SSRIs 
  • Diarrhea (chronic )
  • Sickle cell Anemia
  • Hypercalcemic states 
  • Potassium depletion 
  • Psychogenic Polydipsia due to mental health issues like Anxiety 
  • Cushing’s syndrome
  • Fanconi’s syndrome 
  • Pregnancy 
  • Excessive consumption  of Caffeinated beverages such as coffee and alcoholic drinks

4. How to Diagnose Polyuria?

  • Following a thorough physical examination and history taking for diabetes ,pyelonephritis or obstructive nephropathy,renal vascular disease,systemic lupus erythematosus , meningitis etc  will help to rule out the cause of system failure to some extent 
  • After that a routine urine test for 8 hour,12,24 hour test (quantification of proteinuria) is performed to let know regarding the kidney function 
  • Urine electrophoresis 
  • Urine osmolality 
  • A water deprivation test is done with no fluids intake  for 8 hours until 5%of body weight is lost .The weight and the fluid concentration is checked at regular intervals of time 
  • Blood test include renal function tests to check for the fluid balance maintaining electrolytes,calcium,sodium and few others minerals
  • Estimated sedimentation rate
  • Anti Autobody screen 
  • Blood glucose test 
  • Pituitary function test to check for the Antidiuretic hormone and it’s production 
  • Advanced diagnostic aids such as CT, ultrasound,X rays ,MRI ,Renal biopsies  

5. What are the possible complications of polyuria ?

  • Dehydration, proteinuria,altered blood pressures(postural hypotension) and heart rate(tachycardia/bradycardia), papilloedema
  • Retinal hemorrhage,exudates,cataracts  

6. What is the Treatment for polyuria?

  • Treatment is initiated depending upon the cause and treating accordingly 
  • Consult your physician to confirm the known or unknown cause as early as possible
  • Let your doctor know the medications you use and cut back if not recommended/include if suggested 
  • Check for electrolyte and fluid balance corrections at regular intervals of time to maintain the equilibrium states of the body
  • Diet restrictions and alterations coupled with lifestyle changes of avoiding alcohols and Caffeinated drinks will improve health way better under your dietician concern only 
  • Improving sleep hygiene and health practices such as yoga , meditation can help to relieve anxiety and stress 
  • Maintaining the blood glucose levels or ADH levels under control is the key factor to avoid polyuria 
  • Reducing fluid intake before bedtime, the use of desmopressin

Frequently asked questions

What is polyuria normal range?

The normal range of urine production per day is less than 2 liters ,above 3 liters is considered as polyuria 
Sometimes the production might be around 10 liters/day 
It depends on age and gender

What is the difference between oliguria and polyuria?

Oliguria is low urine output while polyuria means excessive urine output

What kidney disease can cause polyuria?

The kidney disease such as pyelonephritis, obstructive nephropathy,chronic kidney diseases,renal tumors or cancers , glomerulonephropathies or kidney failure can cause polyuria

What deficiency can cause polyuria?

Vitamin D deficiency and loss of its receptors can cause polyuria by increasing thirst or Polydipsia

How does Calcium causes polyuria

Due to increased calcium in blood , impairs the renal concentrating mechanism and also the interstitial osmotic gradient 
In simple terms, it damages the structural and functional activity of kidney 
In clinical terms ,The mechanism involved is due to downregulation of aquaporin water channels  2 and calcium deposition in medulla with tubulointerstitial injury

Can polyuria be cured ?

Yes,it can be cured and treated ,Not very dangerous but should be tracked as early as possible to further prevent the complications in the near future 
Only cured when underlying cause is known through proper diagnosis and investigations

Which electrolyte imbalance causes polyuria 

People with  polyuria have increased serum  sodium   concentration/hypernatremia  because they excrete large quantity of urine  leading to electrolyte imbalance
As we knew that polyuria is due to either water or osmotic diuresis

What are the best medications for polyuria ?

Anticholinergics are the best medications to treat polyuria 
They are 

What blood sugar level causes polyuria

If the sugar levels are around 300 mmol/L – 400 mmol/L it can cause polyuria

Does diet influence polyuria

Diet containing sugars or honey can influence to some extent
As mentioned above consumption of Carbonated/Caffeinated/Alcoholic drinks in excess can also lead to polyuria

What medications can cause polyuria?

Calcium Channel Blockers
Few Medications for Type 2 Diabetes
Tricyclic Antidepressants
Mood Stabilizers
Alpha Blockers 
Nasal Decongestants

Limiting these drugs usage can be of greater advantage in few with no other possible underlying causes.