Polyuria resident survival guide: Difference between revisions
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==Overview== | |||
==Causes== | |||
===Life threatening causes=== | |||
===Common causes=== | |||
==Diagnosis== | |||
==Approach to polyuria== | ==Approach to polyuria== | ||
{{familytree/start |summary=polyuria diagnosis Algorithm.}} | {{familytree/start |summary=polyuria diagnosis Algorithm.}} | ||
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{{familytree | | | | | | | | | | | | | E02 | | |E02=Water restriction test '''OR''' administration of hypertonic saline 0.05 mL/kg/min for 2 h|}} | {{familytree | | | | | | | | | | | | | E02 | | |E02=Water restriction test '''OR''' administration of hypertonic saline 0.05 mL/kg/min for 2 h|}} | ||
{{familytree | | | | | | | | | | | | | |!| | | }} | {{familytree | | | | | | | | | | | | | |!| | | }} | ||
{{familytree | | | | | | | | | | | | | F01 | | | |F01='''Water restriction test'''<br> ❑ Overnight fluid restriction should be '''avoided''' <br> ❑ Recommend the patient to stop drinking 2-3 hours before coming to clinic <br> ❑ Meaure urine volume every hour <br> ❑ Measure urine osmolality every hour <br> ❑ Measure plasma sodium concentration every 2 hours <br> ❑ Measure plasma osmolality every 2 hours |F02=F02}} | {{familytree | | | | | | | | | | | | | F01 | | | |F01='''Water restriction test''' | ||
<br> ❑ Overnight fluid restriction should be '''avoided''' <br> ❑ Recommend the patient to stop drinking 2-3 hours before coming to clinic <br> ❑ Meaure urine volume every hour <br> ❑ Measure urine osmolality every hour <br> ❑ Measure plasma sodium concentration every 2 hours <br> ❑ Measure plasma osmolality every 2 hours |F02=F02}} | |||
{{familytree | | | | | | | | | | | | | |!| }} | |||
{{familytree | | | | | | | | | | | | | G01 |G01='''Test endpoints in adults:''' <br> ❑ Urine osmolality reaches normal value (above 600 mosmol/kg) <br> ❑ The urine osmolality is stable for 2 or 3 successive hourly measurements despite a rising plasma osmolality <br> ❑ Plasma osmolality >295-300 mosmol/kg <br> ❑ Plasma sodium is 145 or higher }} | |||
{{familytree/end}} | {{familytree/end}} | ||
==Treatment== | |||
==Do's== | |||
==Don'ts== | |||
==References== | |||
Revision as of 01:17, 3 June 2018
Overview
Causes
Life threatening causes
Common causes
Diagnosis
Approach to polyuria
| Polyuria ❑ 24-hour urine volume >3L ❑ 24-hour urine volume >50 ml/kg | |||||||||||||||||||||||||||||||||||
| Urine Osmolality >300mosmol | Urine Osmolality <300[1]mosmol | ||||||||||||||||||||||||||||||||||
| Solute diuresis ❑ Glucose ❑ Mannitol ❑ Contrast media ❑ High protein intake ❑ Diuretics ❑ Medullary cystic disease ❑ Resolving ATN ❑ Resolving obstruction | |||||||||||||||||||||||||||||||||||
| Water diuresis ❑ Primary polydipsia ❑ Diabetes inspidous | |||||||||||||||||||||||||||||||||||
| Water restriction test OR administration of hypertonic saline 0.05 mL/kg/min for 2 h | |||||||||||||||||||||||||||||||||||
| Water restriction test
❑ Overnight fluid restriction should be avoided ❑ Recommend the patient to stop drinking 2-3 hours before coming to clinic ❑ Meaure urine volume every hour ❑ Measure urine osmolality every hour ❑ Measure plasma sodium concentration every 2 hours ❑ Measure plasma osmolality every 2 hours | |||||||||||||||||||||||||||||||||||
| Test endpoints in adults: ❑ Urine osmolality reaches normal value (above 600 mosmol/kg) ❑ The urine osmolality is stable for 2 or 3 successive hourly measurements despite a rising plasma osmolality ❑ Plasma osmolality >295-300 mosmol/kg ❑ Plasma sodium is 145 or higher | |||||||||||||||||||||||||||||||||||
Treatment
Do's
Don'ts
References
- ↑ Robertson GL: Diabetes insipidus. Endocrinol Metab Clin North Am 24:549–572, 1995.