Urination - excessive volume

Alternative names
Polyuria

Definition
Polyuria is the release of abnormally large amounts (for an adult, at least 2.5 liters per day) of urine.

Considerations
This is a fairly common symptom which is often noticed when it occurs at night.

Common Causes

     
  • Too much fluid intake, particularly fluids containing caffeine or alcohol  
  • Too much salt or glucose (if diabetic)  
  • Drug use, especially diuretics  
  • Diabetes (both diabetes insipidus and diabetes mellitus)  
  • Psychogenic polydipsia, most common in women over age 30  
  • Renal failure  
  • Sickle cell anemia  
  • Radiographic tests that use a contrast media       o Urine volume will increase for up to 24 hours following the dose

Home Care
Intake and output of fluids should be monitored. Record daily weights at the same time(s) and on the same scales.

Call your health care provider if

     
  • Excessive urination occurs over several days, and it is not explained by medications or increase in fluids.

What to expect at your health care provider’s office
The medical history will be obtained and a physical examination performed.

Medical history questions documenting the excessive urine volume in detail may include:

     
  • Time pattern       o How long has this been noticed?       o Does the volume of urine remain comparable from one day to the next?       o Is the volume large one day and small the next day?       o What time of day does the problem seem worse?  
  • Quality       o What color is the urine?       o Has any blood been noticed in the urine?       o How many times each day is urination necessary? What about at night?       o Any problems controlling urine?  
  • Aggravating factors       o What makes the problem worse?       o Does drinking large volumes of fluid increase the urine volume?  
  • Relieving factors       o Is there anything that helps relieve the problem?       o Does restricting fluid intake reduce the urine volume?  
  • Other       o What other symptoms are also present?           + Is there any pain or burning when urinating?           + Is there back or abdominal pain?           + Is there a fever?           + Is bed wetting a problem?       o What medications are being taken?       o Is there a family history of diabetes or kidney problems?       o Has there been previous urinary tract infections?       o Dietary factors: What is the amount of fluids consumed each day? Salt? Caffeine? Alcohol?

Diagnostic tests that may be performed include:

     
  • Urinalysis  
  • Serum glucose (sugar) test  
  • Blood urea nitrogen test  
  • Creatinine studies  
  • Fluid deprivation test (the intake of fluids is restricted to see if the urine volume decreases)  
  • Serum osmolality and urine osmolality tests  
  • Serum electrolytes

After seeing your health care provider:
You may want to add a diagnosis related to excessive urine volume to your personal medical record.

Johns Hopkins patient information

Last revised: December 7, 2012
by Mamikon Bozoyan, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.