Scribd
Upload
60 views2 pages

Differentials For Polyuria

The document discusses polyuria and its causes. Polyuria is excessive urine output of more than 3 liters per day and can include nocturia. It is often accompanied by polydipsia. The key hormone that regulates water retention and urine production is antidiuretic hormone (ADH). Lack of ADH can lead to central or nephrogenic diabetes insipidus, causing polyuria. Common causes of polyuria include sustained increased water intake, decreased ADH secretion, kidney insensitivity to ADH, and solute diuresis.

Uploaded by

joelh9
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
60 views2 pages

Differentials For Polyuria

The document discusses polyuria and its causes. Polyuria is excessive urine output of more than 3 liters per day and can include nocturia. It is often accompanied by polydipsia. The key hormone that regulates water retention and urine production is antidiuretic hormone (ADH). Lack of ADH can lead to central or nephrogenic diabetes insipidus, causing polyuria. Common causes of polyuria include sustained increased water intake, decreased ADH secretion, kidney insensitivity to ADH, and solute diuresis.

Uploaded by

joelh9
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 2

1

Differentials for polyuria More than 3 litres per day. Can include nocturea. Different from increased frequency of urination. Polyuria often appears in conjunction with polydipsia (increased thirst) Direct control of water excretion is controlled by ADH hormone. The most important roles of ADH is to regulate the body's retention of water; it is released in dehydration and causes the kidneys to conserve water, thus concentrating the urine and reducing urine volume. At high concentrations, it raises blood pressure by vasoconstriction. 1. Receptors in hypothalamus sensitive to increasing plasma osmolarity (when the plasma gets too concentrated). These stimulate ADH secretion. 2. By stretch receptors in heart activated by a larger than normal volume of blood returning to heart. These inhibit ADH secretion, because the body wants to rid itself of the excess fluid volume. The osmolarity of blood (the amount of solute per unit volume) is controlled by aldosterone, a steroid hormone produced by the adrenal cortex. Aldosterone secretion is controlled two ways: 1. The adrenal cortex directly senses plasma osmolarity. When the osmolarity increases, aldosterone secretion is inhibited. The lack of aldosterone causes less sodium to be reabsorbed in the distal tubule. Remember that in this setting ADH secretion will increase to conserve water, thus complementing the effect of low aldosterone levels to decrease the osmolarity of bodily fluids. The net effect on urine excretion is a decrease in the amount of urine excreted, with an increase in the osmolarity of the urine. 2. The kidneys sense low blood pressure (which results in lower filtration rates and lower flow through the tubule). This triggers a complex response to raise blood pressure and conserve volume. Sustained increase in water intake Decrese in ADH secreation Kidney may not be sensitive to ADH Solute diuresis ie losing solute in urine. electrolytes (eg, sodium chloride sodium bicarbonate), by nonelectrolytes (eg, glucose, urea).

Pathology of polyurea

review water retention

4 causes

What is Central diabetes insipidus and nephrogenic diabetes inspidus.

List causes for Polydipsia Qs for Hxx

Red flags

Central diabetes inspidus -rare condition it occurs when the body has too little of the hormone vasopressin. Following surgery, brain injury, tumour or born with it. Nephrogenic diabetes insipidus - caused by an improper response of the kidney to ADH, leading to a decrease in the ability of the kidney to concentrate the urine by removing free water. Excesive thirst. Can be caused by diabetes, haemorrhage, lesions in thirst centre, alcohol, and caffeine. Ask to describe voiding to distinguish between polyuria and increased urinary frequency. Age, onset, ask dry eyes-schrogens syndrome. Fam hxx, drug hxx Abrupt start (suggests central diabetes inspidus), night sweats, weight loss, psychiatric conditions.

You might also like