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Polyuric states in man.

C J Thompson

    Bailliere'S Clinical Endocrinology and Metabolism
    |August 1, 1989
    PubMed
    Summary
    This summary is machine-generated.

    This review covers polyuria, focusing on causes like surgery and head injury. Desmopressin is effective for Central Diabetes Insipidus (CDI), but Nephrogenic Diabetes Insipidus (NDI) treatment remains challenging.

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    Area of Science:

    • Endocrinology
    • Nephrology
    • Pathophysiology

    Background:

    • Polyuria, characterized by excessive urine production, has diverse pathophysiological underpinnings.
    • Causes of Central Diabetes Insipidus (CDI) include idiopathic, post-surgical, head trauma, and autoimmune variants.
    • Nephrogenic Diabetes Insipidus (NDI) presents distinct challenges in management.

    Purpose of the Study:

    • To review the pathophysiological basis of polyuria.
    • To detail the causes of Central Diabetes Insipidus (CDI) and Nephrogenic Diabetes Insipidus (NDI).
    • To evaluate diagnostic methods and therapeutic strategies for polyuria.

    Main Methods:

    • Review of existing literature on polyuria mechanisms, causes, and treatments.
    • Discussion of diagnostic accuracy of indirect methods versus plasma arginine vasopressin (AVP) measurements.

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  • Assessment of therapeutic options including desmopressin, thiazide diuretics, and indomethacin.

    • Main Results:

    • Indirect polyuria investigations show significant inaccuracies.
    • Integrating plasma AVP measurements into water deprivation tests or hypertonic saline infusion enhances diagnostic precision.
    • Desmopressin offers a safe and effective treatment for most CDI patients.
    • Complete abolition of polyuria in NDI is not achieved with current therapies like thiazide diuretics or indomethacin.

    Conclusions:

    • Accurate diagnosis of polyuria requires improved methods beyond indirect testing.
    • Desmopressin is the recommended therapy for Central Diabetes Insipidus (CDI).
    • Management of Nephrogenic Diabetes Insipidus (NDI) primarily relies on maintaining adequate fluid intake due to limited treatment efficacy.