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Chapter-16 Approach to Polyuria

BOOK TITLE: Principles and Practice of Pediatric Nephrology

Author
1. Sairam VK
ISBN
9788180613043
DOI
10.5005/jp/books/11074_16
Edition
1/e
Publishing Year
2004
Pages
5
Author Affiliations
1. Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India, Kanchi Kamacoti Childs Trust Hospital, Chennai, Tamil Nadu, India
Chapter keywords

Abstract

Polyuria is defined as an excessive urinary output over a time interval. It is in excess of 4-5ml/kg/hour consistently over a specified period. Polyuria in children is either due to inadequate response to AVP at the collecting tubule or a decreased production of AVP (central diabetes insipidus—CDI) or a normal AVP production and function, but related to solute diuresis or natriuresis. Clinical manifestations depend on the etiology of polyuria. For example, an infant with congenital NDI shows evidence of the disease with polyuria and symptoms of excessive crying and irritability secondary to thirst. The definitive diagnosis can be obtained by inducing hyperosmolality with complete water restriction, thereby stimulating endogenous ADH production and raising the urine osmolality.

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