Urination - excessive volume

• Alternative Names

  Polyuria

• Considerations

  An excessive volume of urination for an adult is more than 2.5 liters of urine per day.

  Polyuria is a fairly common symptom, which is often noticed when you have to get up to use the bathroom at night.

• Common Causes
  • Drinking a large amount of fluids, particularly those containing caffeine or alcohol
  • Certain medications, especially diuretics
  • Diabetes mellitus
  • Diabetes insipidus
  • Psychogenic polydipsia, most common in women over age 30
  • Kidney failure
  • Sickle cell anemia
  • Imaging tests that involve injecting a special dye (contrast media) into your vein -- the amount of urine you produce may increase for up to 24 hours afterwards
• Home Care

  You should keep track of the following every day:

  • How much you drink
  • How often you urinate and how much urine you produce each time
  • How much you weigh (use the same scale every day)
• Call your health care provider if

  Call your doctor if you have excessive urination over several days, and it is not explained by medications or increase in fluids.

• What to expect at your health care provider's office

  Your health care provider will perform a physical exam and ask you questions about your medical history and symptoms, including:

  • Time pattern
    • How long has you noticed this problem?
    • Do you produce the same amount of urine every day?
    • What time of day does the problem seem worse?
  • Quality
    • What color is the urine?
    • Do you have blood in your urine?
    • How many times each day do you urinate? What about at night?
    • Any problems controlling urine?
  • Aggravating factors
    • What makes the problem worse?
    • Does drinking large volumes of fluid make you produce more urine?
  • Relieving factors
    • Does anything help relieve the problem?
    • Does restricting fluid intake reduce the urine volume?
  • Other
    • What other symptoms do you have?
      • Do you have any pain or burning when urinating?
      • Do you have back or abdominal pain?
      • Have you had a fever?
      • Is bed wetting a problem?
    • What medications do you take?
    • Do you have a family history of diabetes or kidney problems?
    • Have you had a previous urinary tract infection?
  • Dietary factors
    • How much do you drink every day?
    • How much caffeine do you have each day?
    • How much alcohol do you drink each day?
    • How much salt do you use each day?

  Tests that may be done include:

  • Blood glucose (sugar) test
  • Blood urea nitrogen test
  • Creatinine studies
  • Electrolytes
  • Fluid deprivation test (the intake of fluids is restricted to see if the urine volume decreases)
  • Osmolality blood test
  • Urine osmolality test
  • Urinalysis
• References

  Gerber GS, Brendler CB. Evaluation of the urologic patient: History, physical examination, and the urinalysis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 3.

Review Date: 9/30/2009

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.