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Chapter: Paediatrics: Nephrology

Paediatrics: Polyuria and frequency

This is often subjective and difficult to assess, particularly in small children.

Polyuria and frequency

 

This is often subjective and difficult to assess, particularly in small children. Frequency can be considered to be the inappropriate and frequent pas-sage of small amounts of urine. Polyuria can be quantitatively defined as the passage of greater than 2000mL/1.73m2 per 24hr period.

 

Assessment of polyuria and frequency requires a detailed history of uri-nary frequency habit.

 

Causes of polyuria

 

   Renal disorders:

o chronic kidney disease;

o post-obstructive uropathy;

o nephrogenic diabetes insipidus;

o Fanconi syndrome.

   Metabolic/endocrine disorders:

o diabetes mellitus;

o cranial diabetes inspidus;

o hypoadrenalism.

·  Excess and inappropriate water intake: psychogenic polydipsia.

 

Causes of urinary frequency

 

   Urinary tract infection.

 

   Bladder irritability and instability.

 

   All causes of polyuria.

 

   Small bladder capacity.

 

Investigations

 

Baseline screening investigations should include the following.

 

Urine

 

   Urinalysis by urine dipstick testing.

 

   Urine culture.

 

   Urine osmolality.

 

Blood

 

   Urea and electrolytes.

 

   Plasma osmolality.

 

 

   Blood glucose (random or fasting).

 

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Paediatrics: Nephrology : Paediatrics: Polyuria and frequency |


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