Polyuria
If you have a condition called polyuria, it’s because your body makes more urine than normal. Adults usually make about 3 liters of urine per day. But with polyuria, you could make up to 15 liters per day. It's a classic sign of diabetes.
Causes of Polyuria
Type 1 and type 2 diabetes
Polyuria is often one of the first signs of diabetes. The condition makes sugar build up in your bloodstream. If your kidneys aren’t able to filter it out, it exits your body in your urine. As the extra sugar and fluids travel through your kidneys, you have to pee more. Plus, the more you go, the thirstier you feel, and the more you’ll drink.
Diabetes insipidus
With this rare condition, your body isn’t able to control its fluid levels. As a result, you feel very thirsty no matter how much you drink. Diabetes insipidus can happen because of kidney problems or an issue in the brain from surgery, a tumor, infection, or a head injury.
Pregnancy
Mothers-to-be can get gestational diabetes insipidus. It usually goes away when you’re no longer pregnant. Kidney disease or failure. Damaged kidneys can’t process urine like they’re supposed to. Polyuria can often be an early sign of kidney trouble.
Liver disease
Problems with your liver can also affect your kidneys. Your liver can’t process waste like it should, and liver damage reduces the blood flow to your kidneys so they can’t do their job.
Cushing’s syndrome
This is when you have too much cortisol in your body. The extra cortisol affects ADH (antidiuretic hormone), a hormone involved in urine production.
Hypercalcemia
Too much calcium in your blood can affect your ADH levels or your kidneys’ response to it. It can also affect the way your kidneys process urine. Anxiety
There’s a link between anxiety and vasopressin, a substance the helps kidneys hold onto water.
Medications
Different drugs can lead to polyuria:
Calcium channel blockers - These medications open your blood vessels and can lead to your body making more urine.
Diuretics - These medications help you move water and salts out of your body.
Lithium - This medication for bipolar disorder can damage your kidneys.
SSRI - This group of drugs is used to treat depression but can prevent your body from making ADH.
Tetracycline - Demeclocycline, a form of this antibiotic, can affect ADH production.
Alcohol
It prevents your body from releasing ADH.
Caffeine
It makes you urinate more.
Symptoms of Polyuria
As well as being one of the symptoms of undiagnosed diabetes, polyuria can also occur in people with diagnosed diabetes if blood glucose levels have risen too high.
If blood glucose levels become too high, the body will try to remedy the situation by removing glucose from the blood through the kidneys.
When this happens, the kidneys will also filter out more water and you will need to urinate more than usual as a result.
If you are frequently experiencing an increased need to urinate, it could be a sign that your sugar levels are too high.
If you have access to blood glucose testing strips, you may wish to test your sugar levels if you are urinating more often than normal.
If you have diabetes but don’t have blood glucose testing supplies, you may wish to note down how often you are urinating and discuss this with your health team.
Your health team should be able to advise whether the problem may be related to diabetes and any remedial action you can take.
Diagnosis of Polyuria
Physical exam
They’ll check for signs that you might have diabetes as well as other mental and physical conditions linked to polyuria.
And they’ll look for swelling in your hands, feet, or belly.
They’ll look for things that can cause diabetes insipidus, like cancer, Sjogren’s syndrome, antidepressants, and hypercalcemia.
Urine test
Your doctor might use an 8, 12- or 24-hour test: You’ll get a special container and you’ll pee into it over a 24-hour period and take it back.
When the 24 hours are up, go once more, add that urine, and note the time. Keep it cool until you can return it.
The test looks for the same things as a random test, but gathering urine over a longer period gives the doctor a better idea of what’s in it.
A water deprivation test can help decide how well your kidneys work when ADH is in your system.
You’ll have no fluids either for 8 hours or until you’ve lost 5% of your body weight.
Your weight and urine concentration will be tested at regular intervals.
Blood tests
These will check for electrolytes, calcium, and sodium.
Glucose test
Your doctor will check your blood sugar to see if you have diabetes.
Pituitary function test
This gland makes ADH. If something is wrong with it, your production could be off.
Treatment of Polyuria
How you stop polyuria depends on the causative factor for it.
For example, if you have diabetes that isn’t under control, you may need to make changes to your treatments.
If a medicine you take is the cause, talk to your doctor about switching to another drug or changing your dose.
At home, cut back on how much fluid you drink, especially those that have alcohol and caffeine.