Introduction:
Polyuria, defined as urine output exceeding 3 L/day in adults, is not uncommon in clinical practice. The purpose of this case series is to highlight varied causes of Polyuria along with different treatment modalities .
Methods:
We retrospectively analyzed the data of patients referred to nephrology for polyuria between January 2022 -December 2023. Clinical history, blood and urine biochemistry (including sodium and osmolality), daily urine volume were reviewed by three nephrologists independently and a consensus was reached about the diagnosis and treatment plan.
Results:
Twenty one patients (16 male) with a mean± SD age 48.09 ± 19.2 years were evaluated for polyuria. Average urine output at presentation was 5.07 lt /day. Majority (11) of patients had neurological insult or neuro-intervention (Neuro group). This was followed by post uro-deobstruction nephrogenic DI (6, Uro group). Plasma sodium, urine osmolality, urine sodium in neuro vs uro group were analyzed. The Neuro group had an average urinary osmolality of 242.5 ± 110, while the Uro group had an average of 232.02 ± 111.06 with p-value of 0.81. Patients in the neuro group had polyuria mostly due to cerebral salt wasting followed by central DI. They received fludrocortisone and desmopressin respectively & average time taken to respond to treatment was 5 days .
Conclusions:
Commonest diagnosis in polyuric patients with neurological insults was cerebral salt wasting & treated with fludrocortisone and normal saline with an average duration to response of 5 days.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.