Urination - excessive volume

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.

Causes

• Diabetes insipidus
• Diabetes mellitus
• Drinking a large amount of fluids, especially fluids that contain caffeine or alcohol
• Kidney failure
• Medications, especially diuretics
• Psychogenic polydipsia (most common in women over age 30)
• Sickle cell anemia
• Tests such as CT scans, 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

If you are concerned about the amount you urinate, 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)

When to Contact a Medical Professional

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

What to Expect at Your Office Visit

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

• Time pattern
  • For how long have you noticed this problem?
  • Do you produce the same amount of urine every day?
  • At what time of day does the problem seem worse?
• Quality
  • What color is your urine?
  • Do you have blood in your urine?
  • How many times each day do you urinate? What about at night?
  • Do you have any problems controlling your urine?
• Factors that make the problem worse
  • What makes the problem worse?
  • Does drinking large volumes of fluid make you produce more urine?
• Factors that make the problem better
  • Does anything help relieve the problem?
  • Does limiting fluid reduce your 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 bedwetting a problem?
  • What medications do you take?
  • Do you have a family history of diabetes or kidney problems?
  • Have you had a past 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 sugar (glucose) test
• Blood urea nitrogen test
• Creatinine (serum)
• Electrolytes (serum)
• Fluid deprivation test (limiting fluids to see if the urine volume decreases)
• Osmolality blood test
• Urinalysis
• Urine osmolality test

Alternative Names

Polyuria

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.

Landry DW, Bazari H. Approach to the patient with renal disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 116.

Update Date: 9/16/2011

Updated 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.