Polyuria (Excessive Urine Production)

What Is Polyuria?

Do you always have to go? If you have a condition called polyuria, it’s because your body makes more pee than normal.

Adults usually make about 3 liters of urine per day. But with polyuria, you could make up to 15 liters per day. It's a classic sign of diabetes.

A few other conditions make you need to pee more often, such as an overactive bladder, an enlarged prostate, and urinary tract infections. They can make you feel like you have to go all the time, even if there isn’t much in your bladder. But polyuria makes you have to go more often because your body makes more urine.

What Are the Symptoms of Polyuria?

Besides making a lot of pee, you might also:

  • Feel thirsty. You're losing a lot of fluid, and that can lead to dehydration.
  • Wake up often at night. Your urge to go doesn't stop when you sleep. 

What Causes Polyuria?

Things that can cause you to make too much urine include:

  • Type 1 and type 2 diabetesPolyuria is often one of the first signs of diabetes. The condition makes sugar build up in your bloodstream. If your kidneys aren’t able to filter it out, it exits your body in your urine. As the extra sugar and fluids travel through your kidneys, you have to pee more. Plus, the more you go, the thirstier you feel, and the more you’ll drink.
  • Diabetes insipidus. With this rare condition, your body isn’t able to control its fluid levels. As a result, you feel very thirsty no matter how much you drink. Diabetes insipidus can happen because of kidney problems or an issue in the brain from surgery, a tumor, infection, or a head injury.
  • Pregnancy. Mothers-to-be can get gestational diabetes insipidus. It usually goes away when you're no longer pregnant.
  • Kidney disease or failure. Damaged kidneys can’t process urine like they’re supposed to. Polyuria can often be an early sign of kidney trouble.   
  • Liver disease. Problems with your liver can also affect your kidneys. Your liver can’t process waste like it should, and liver damage reduces the blood flow to your kidneys so they can’t do their job.
  • Cushing's syndrome. This is when you have too much cortisol in your body. The extra cortisol affects ADH (antidiuretic hormone), a hormone involved in urine production.
  • Hypercalcemia. Too much calcium in your blood can affect your ADH levels or your kidneys’ response to it. It can also affect the way your kidneys process urine. 
  • Anxiety. There’s a link between anxiety and vasopressin, a substance the helps kidneys hold onto water.
  • Medications. Different drugs can lead to polyuria:
    • Calcium channel blockers. These medications open your blood vessels and can lead to your body making more urine.
    • Diuretics. These medications help you move water and salts out of your body.
    • Lithium. This medication for bipolar disorder can damage your kidneys.
    • SSRIs. This group of drugs is used to treat depression but can prevent your body from making ADH.
    • Tetracycline. Demeclocycline, a form of this antibiotic, can affect ADH production.
  • Alcohol. It prevents your body from releasing ADH.
  • Caffeine. It makes you pee more.

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Diagnosing Polyuria

Your doctor looks at many things to diagnose polyuria.

  • Symptoms. They’ll ask about the amount of fluid your body makes and how thirsty you are.
  • History. Your doctor will ask you when your symptoms started and check on any medical treatments that could cause it, like getting fluids, tube feeding, a urinary blockage, surgery, stroke, or head trauma.
  • Physical exam. They’ll check for signs that you might have diabetes as well as other mental and physical conditions linked to polyuria. And they’ll look for swelling in your hands, feet, or belly. They’ll look for things that can cause diabetes insipidus, like cancer, Sjogren’s syndrome, antidepressants, and hypercalcemia.
  • Urine test. Your doctor might use an 8, 12- or 24-hour test: You’ll get a special container and you’ll pee into it over a 24-hour period and take it back. When the 24 hours are up, go once more, add that urine, and note the time. Keep it cool until you can return it. The test looks for the same things as a random test, but gathering urine over a longer period gives the doctor a better idea of what’s in it.

A water deprivation test can help decide how well your kidneys work when ADH is in your system. You’ll have no fluids either for 8 hours or until you’ve lost 5% of your body weight. Your weight and urine concentration will be tested at regular intervals.

  • Blood tests. These will check for electrolytes, calcium, and sodium.
  • Glucose test. Your doctor will check your blood sugar to see if you have diabetes.
  • Pituitary function test. This gland makes ADH. If something is wrong with it, your production could be off.

Polyuria Treatment

How you stop polyuria depends on what’s causing it. For example, if you have diabetes that isn’t under control, you may need to make changes to your treatments. If a medicine you take is the cause, talk to your doctor about switching to another drug or changing your dose.

At home, cut back on how much fluid you drink, especially those that have alcohol and caffeine.

WebMD Medical Reference Reviewed by Michael Dansinger, MD on June 12, 2019

Sources

SOURCES:

BJU International: “Nocturia as a Manifestation of Systemic Disease.”

Mayo Clinic: “Diabetes Insipidus,” “Frequent Urination,” “Overactive Bladder,” “Urinary Tract Infection,” “Diabetes symptoms: When Diabetes Symptoms Are a Concern.”

Cleveland Clinic: “Nocturia.”

Medscape: “Chronic Kidney Disease,” “Endogenous Cushing Syndrome,” “What effect does cortisol have on antidiuretic hormone (ADH) and corticotropin-releasing hormone?”

World Journal of Gastroenterology: “Kidneys in chronic liver diseases.”

UpToDate: “Evaluation of patients with polyuria,” “Renal toxicity of lithium.”

StatPearls: “Vasopressin.”

Mayo Clinic: “Calcium channel blockers,” “Diuretics,” “Hypercalcemia.”

American Journal of Nephrology: “Mechanism of the Polyuria of Hypercalcemia.”

The European Journal of Neuroscience: “Diabetes insipidus and, partially, low anxiety-related behaviour are linked to a SNP-associated vasopressin deficit in LAB mice.”

Endocrinology, Diabetes & Metabolism Case Reports: “Transient diabetes insipidus in pregnancy.”

American Family Physician: “Nocturia.”

Indian Journal of Psychiatry: “Syndrome of inappropriate ADH secretion (SIADH) associated with citalopram use.”

NIH LiverTox: “Demeclocycline.”

You and Your Hormones: “Anti-diuretic hormone.”

Oregon State University: “Anatomy & Physiology.”

Merck Manual: “Polyuria.”

Lab Tests Online: “Timed Urine Sample.”

Cancer Research UK: “Urine Test.”

Endocrine Abstracts: “How to do a water deprivation test: interpretation of results.”

The Pituitary Foundation: “What is diabetes insipidus?”

Diabetes.co.uk: “Polyuria - Frequent Urination.”

Urology Care Foundation: “What is Nocturia?”

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