Polyuria resident survival guide: Difference between revisions
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{{ | ==Approach to polyuria== | ||
{{familytree | | {{familytree/start |summary=polyuria diagnosis Algorithm.}} | ||
❑ | {{familytree | | | | | | | | A01 |A01='''Polyuria'''<br> ❑ 24-hour urine volume >'''3'''L <br> ❑ 24-hour urine volume >50 ml/kg}} | ||
{{familytree | | | | |,|-|-|-|^|-|-|-|-|.| | | }} | |||
{{familytree | | | B01 | | | | | | | | B02 | | |B01='''Urine Osmolality >300'''mosmol|B02='''Urine Osmolality <300<ref>Robertson GL: Diabetes insipidus. Endocrinol Metab Clin North Am 24:549–572, 1995.</ref>'''mosmol}} | |||
{{familytree | | | |!| | | | | | | | | |!| }} | |||
{{familytree | | | C01 | | | | | | | | |!| |C01='''Solute diuresis'''<br> ❑ [[Glucose]] <br> ❑ [[Mannitol]] <br> ❑ [[Contrast media]] <br> ❑ [[High protein intake]] <br> ❑ [[Diuretics]] <br> ❑ [[Medullary cystic disease]] <br> ❑ [[Resolving ATN]] <br> ❑ [[Resolving obstruction]] }} | |||
{{familytree | | | | | | | | | | | | | |!| }} | |||
{{familytree | | | | | | | | | | | | | D03 |D03='''Water diuresis'''<br> ❑ [[Primary polydipsia]] <br> ❑ [[Diabetes inspidous]]}} | |||
{{familytree | | | | | | | | | | | | | |!| | }} | |||
{{familytree | | | | | | | | | | | | | E02 | | |E02=Water restriction test '''OR''' administration of hypertonic saline 0.05 mL/kg/min for 2 h|}} | |||
{{familytree | | | | | | | | | | | | | |!| | | }} | |||
{{familytree | | | | | | | | | | | | | F01 | | | |F01='''Water restriction test'''<br> ❑ Overnight fluid restriction should be '''avoided''' <br> ❑ Recommend the patient to stop drinking 2-3 hours before coming to clinic <br> ❑ Meaure urine volume every hour <br> ❑ Measure urine osmolality every hour <br> ❑ Measure plasma sodium concentration every 2 hours <br> ❑ Measure plasma osmolality every 2 hours |F02=F02}} | |||
{{familytree/end}} | |||
Revision as of 00:52, 3 June 2018
Approach to polyuria
| Polyuria ❑ 24-hour urine volume >3L ❑ 24-hour urine volume >50 ml/kg | |||||||||||||||||||||||||||||||||||
| Urine Osmolality >300mosmol | Urine Osmolality <300[1]mosmol | ||||||||||||||||||||||||||||||||||
| Solute diuresis ❑ Glucose ❑ Mannitol ❑ Contrast media ❑ High protein intake ❑ Diuretics ❑ Medullary cystic disease ❑ Resolving ATN ❑ Resolving obstruction | |||||||||||||||||||||||||||||||||||
| Water diuresis ❑ Primary polydipsia ❑ Diabetes inspidous | |||||||||||||||||||||||||||||||||||
| Water restriction test OR administration of hypertonic saline 0.05 mL/kg/min for 2 h | |||||||||||||||||||||||||||||||||||
| Water restriction test ❑ Overnight fluid restriction should be avoided ❑ Recommend the patient to stop drinking 2-3 hours before coming to clinic ❑ Meaure urine volume every hour ❑ Measure urine osmolality every hour ❑ Measure plasma sodium concentration every 2 hours ❑ Measure plasma osmolality every 2 hours | |||||||||||||||||||||||||||||||||||
- ↑ Robertson GL: Diabetes insipidus. Endocrinol Metab Clin North Am 24:549–572, 1995.