title: Evaluation of Polyuria: The Roles of Solute Loading and Water Diuresis.
abstract: Polyuria, defined as daily urine output in excess of 3.0 to 3.5L/d, can occur due to solute or water diuresis. Solute-induced polyuria can be seen in hospitalized patients after a high solute load from exogenous protein administration or following relief of urinary obstruction. Similar clinical scenarios are rarely encountered in the outpatient setting. We describe a case of polyuria due to high solute ingestion and excessive water intake leading to a mixed picture of solute and water diuresis. Restriction of the daily solute load and water intake resulted in complete resolution of polyuria. Determination of the daily excreted urinary osmoles may yield important clues to the cause of polyuria and should be included in the routine workup of polyuria.
authors.affiliation: Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, SC. Electronic address: bhasinb@musc.edu.
authors.forename: Bhavna
authors.initials: B
authors.lastname: Bhasin
authors.affiliation: Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, SC; Section of Nephrology, Medical Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC.
authors.forename: Juan Carlos Q
authors.initials: JC
authors.lastname: Velez
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004044:Dietary Proteins / Q000032:analysis / Q000378:metabolism; D019468:Disease Management; D004231:Diuresis / Q000502:physiology; D004326:Drinking / Q000502:physiology*; D005260:Female; D006801:Humans; D009994:Osmolar Concentration; D011141:Polyuria / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D011188:Potassium / Q000032:analysis / Q000378:metabolism; D012964:Sodium / Q000032:analysis / Q000378:metabolism; D016896:Treatment Outcome; D014883:Water-Electrolyte Imbalance / Q000209:etiology / Q000628:therapy / Q000652:urine
chemical_list: D004044:Dietary Proteins; D012964:Sodium; D011188:Potassium
keywords: Polyuria; hypernatremia; solute excretion; urinary osmoles; water diuresis