WordNet

renal disorder characterized by the production of large volumes of pale dilute urine; often associated with diabetes
increased secretion of urine; if not due to increased liquid intake or to the action of a diuretic drug it can be a symptom of diabetes mellitus

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/01/05 11:51:30」(JST)

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Not to be confused with polyurea.

Polyuria is a condition usually defined as excessive or abnormally large production or passage^[1] of urine (at least 2.5^[2] or 3^[3] L over 24 hours in adults). Frequent urination is sometimes included by definition,^[4] but is nonetheless usually an accompanying symptom. Increased production and passage of urine may also be termed diuresis.^[5]^[6]

Polyuria often appears in conjunction with polydipsia (increased thirst), though it is possible to have one without the other, and the latter may be a cause or an effect. Psychogenic polydipsia may lead to polyuria.

Polyuria is physiologically normal in some circumstances, such as cold diuresis, altitude diuresis, and after drinking large amounts of fluids.

Causes

The most common cause of polyuria in both adults and children is uncontrolled diabetes mellitus,^[3] causing an osmotic diuresis. In the absence of diabetes mellitus, the most common causes are primary polydipsia (excessive fluid drinking), central diabetes insipidus and nephrogenic diabetes insipidus.^[3]

Polyuria may also be due to various chemical substances (diuretics, caffeine, alcohol). It may also occur after supraventricular tachycardias, during an onset of atrial fibrillation, childbirth, and the removal of an obstruction within the urinary tract. Diuresis is restrained by antidiuretics such as ADH, angiotensin II and aldosterone.

Cold diuresis is the occurrence of increased urine production on exposure to cold, which also partially explains immersion diuresis.

Substances that increase diuresis are called diuretics.

Substances that decrease diuresis allow more vasopressin or antidiuretic hormone (ADH) to be present in the kidney.

High-altitude diuresis occurs at altitudes above 10,000 ft and is a desirable indicator of adaptation to high altitudes. Mountaineers who are adapting well to high altitudes experience this type of diuresis. Persons who produce less urine even in the presence of adequate fluid intake probably are not adapting well to altitude.^[7]

List of causes

increase in fluid intake, especially water
diuretic drugs
diuretic foods (foods and beverages containing caffeine, such as chocolate, coffee, tea, and soft drinks; hot spicy foods; juices high in acid; alcoholic beverages; protein shakes, etc.)
diabetes mellitus
diabetes insipidus
psychogenic polydipsia
high doses of riboflavin (vitamin B₂)
high doses of vitamin C
cold diuresis
Chronic Fatigue Syndrome
Cerebral salt-wasting syndrome
altitude diuresis
interstitial cystitis
interstitial nephritis
lupus erythematosus or other connective tissue disease related cystitis
Sjögren's syndrome
Postural orthostatic tachycardia syndrome (POTS)
renal tubular acidosis
Fanconi syndrome/renal glycosuria
hypercalcaemia
hyperthyroidism
hypopituitarism
hypogonadism
Conn's disease (Primary aldosteronism)
pregnancy
reactive arthritis/Reiter's syndrome
glomerulonephritis
squamous cell carcinoma of lung (a paraneoplastic consequence)
hypoaldosteronism
hypokalemia
polydipsia
congestive heart failure
Cushing's syndrome
Addison's disease
intestinal obstruction (occurs after toxins begin to be absorbed from the damaged intestine)
hyperparathyroidism^[8]
acromegaly
polycythemia
partial obstruction of the urinary tract
pheochromocytoma
side effect of lithium (see lithium thirst)
liver failure/ cirrhosis
pyometra in certain animals or appendicitis in humans
neurologic damage
urinary tract infection - although it more commonly causes frequent passage of small volumes of urine rather than a large volume
emphysematous cystitis
post supraventricular tachycardia
migraine
Use of a corticosteroid such as prednisone
nephronophthisis
Hyperglycaemia (often secondary to diabetes mellitus)
Hypoxia
Hypovolemia
Chronic Renal Failure
Removal of Urinary Obstruction
Healing Acute Tubular Necrosis
Forced diuresis
Osmotic diuresis
Rebound diuresis
Immersion diuresis
Pollakiuria

References

^ thefreedictionary.com > polyuria. Citing:
- "Excessive passage" - The American Heritage Medical Dictionary Copyright 2007
- "Excessive production" - Gale Encyclopedia of Medicine. Copyright 2008
- "the formation and excretion" - Saunders Comprehensive Veterinary Dictionary, 3 ed. 2007
^ http://www.nlm.nih.gov/medlineplus/ency/article/003146.htm Last Editorial Review: 9/30/2009
^ ^a ^b ^c merck.com > Polyuria: A Merck Manual of Patient Symptoms podcast. Last full review/revision September 2009 by Seyed-Ali Sadjadi, MD
^ Acknowledgements patient.co.uk > Polyuria By Dr Colin Tidy. Document ID: 2632. Document Version: 21. Document Reference: bgp113. Last Updated: 6 Jul 2009
^ MedicineNet.com > Definition of Diuresis Last Editorial Review: 8/20/2002
^ thefreedictionary.com > diuresis Retrieved on June 13, 2010
^ Hackett, Peter H. Mountain Sickness, The American Alpine Club, 1980. pp. 54, 62)
^ eMedicine - Hyperparathyroidism : Article by James LaBagnara

UpToDate Contents

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1. 多尿および尿崩症の診断 diagnosis of polyuria and diabetes insipidus
2. 夜間頻尿：臨床症状、診断、および治療治療 nocturia clinical presentation diagnosis and treatment
3. 腎性尿崩症の臨床症状および原因 clinical manifestations and causes of nephrogenic diabetes insipidus
4. 中枢性尿崩症の臨床症状および原因 clinical manifestations and causes of central diabetes insipidus
5. 好酸球の生物学および好酸球増多症の原因 eosinophil biology and causes of eosinophilia

English Journal

Lithium nephrotoxicity.

Azab AN1, Shnaider A, Osher Y, Wang D, Bersudsky Y, Belmaker RH.
International journal of bipolar disorders.Int J Bipolar Disord.2015 Dec;3(1):28. doi: 10.1186/s40345-015-0028-y. Epub 2015 Jun 5.
Reports of toxic effects on the kidney of lithium treatment emerged very soon after lithium therapy was introduced. Lithium-induced nephrogenic diabetes insipidus is usually self-limiting or not clinically dangerous. Some reports of irreversible chronic kidney disease and renal failure were difficul
PMID 26043842

Nocturia: Current Evaluation and Treatment for Urology.

Nimeh T1, Alvarez P, Mufarreh N, Lerner LB.
Current urology reports.Curr Urol Rep.2015 Sep;16(9):533. doi: 10.1007/s11934-015-0533-7.
Nocturia is a very common yet a highly underreported entity. Recently, there has been an increasing interest in nocturia because of its association with serious adverse health conditions such as diabetes, heart disease, elevated BMI, and mortality. Frequency volume charts are the cornerstone of init
PMID 26231263

Neighbourhood fluorosis in people residing in the vicinity of superphosphate fertilizer plants near Udaipur city of Rajasthan (India).

Choubisa SL1, Choubisa D.
Environmental monitoring and assessment.Environ Monit Assess.2015 Aug;187(8):4723. doi: 10.1007/s10661-015-4723-z. Epub 2015 Jul 10.
Chronic industrial fluoride toxicosis in the forms of dental, skeletal and non-skeletal fluorosis was investigated in 162 villagers (94 males and 78 females) above 15 years of age living in the vicinity of superphosphate fertilizer plants located approximately 12 km south of Udaipur city of Rajast
PMID 26160742

Japanese Journal

症例特発性中枢性尿崩症に肺癌を合併し,多尿の診断と治療に苦慮した1例

朝戸裕子,大谷すみれ,倉持みずき [他]
日本呼吸器学会誌 = Annals of the Japanese Respiratory Society 3(3), 385-389, 2014-05-10
NAID 40020110506

症例報告夜間頻尿にデスモプレシンが著効した高齢女性の1症例

栢森健介,藤谷順子,河内正治
日本老年医学会雑誌 51(1), 85-88, 2014-01
NAID 40020006736

Comparison of incidence of hyponatremia between intranasal and oral desmopressin in patients with central diabetes insipidus

Kataoka Yuko,Nishida Sachi,Hirakawa Akihiro,Oiso Yutaka,Arima Hiroshi
Endocrine Journal, 2014
… Central diabetes insipidus (CDI), which is characterized by polyuria and polydipsia, is caused by a deficiency of the antidiuretic hormone arginine vasopressin (AVP). …
NAID 130004713044

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