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S. Faubel and J. Topf9 Polydipsia, Polyuria

9 Polydipsia, Polyuria

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The Fluid, Electrolyte and Acid-Base Companion

Polydipsia is increased thirst that triggers the ingestion of water. Thereare two reasons for a patient to be polydipsic and ingest water:

Fighting hyperosmolality

. Thirst and water ingestion are theappropriate responses to plasma hyperosmolality.

Psychogenic polydipsia

. Patients with psychogenic polydipsiavoluntarily drink enormous amounts of water.

Introduction



Polydipsia is defined as increased thirst.

Polydipsia

Fighting againsthyperosmolality

There are ______ general causes of polydipsia:•Intact _______ mechanism in a patient who is battlinghyperosmolality.•_________ polydipsia.twothirstPsychogenic

Ingestion of water is the primary defense against hypernatremia.This topic is reviewed inChapter 8,

Hypernatremia

.Medical Greek:

Polydipsia

is a term which refers to excessive

thirst

that is typically chronic.A common misconception is that polydipsia refers to the excess ingestion of water.

Polys:much, many; dipsa: thirst.

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S. Faubel and J. Topf9 Polydipsia, Polyuria

Polydipsia and polyuria have an interesting relationship because eitherone can cause the other.

Polyuria causing polydipsia

occurs when large amounts of hypo-tonic fluid are lost in the urine. To compensate for water lost in the urine,the patient ingests large amounts of water to maintain normal plasma os-molality. Polyuria causing polydipsia is from fighting hyperosmolality.

Polydipsia causing polyuria

is due to psychogenic polydipsia. Theingestion of large quantities of water dilutes plasma osmolality which sup-presses ADH. Decreased ADH activity allows excretion of the excess ingestedwater.

Introduction



Polyuria, increased urine output, can cause or re-sult from polydipsia.

Polyuria

olydipsia

Polydipsia

; ; ; ;

Polyuria causing polydipsia is due to the increased loss of hypo-tonic _______. The battle against hyperosmolality is fought by_______ and the ingestion of water.Psychogenic polydipsia is the voluntary ingestion of large quan-tities of water which causes _________.aaaurinethirstpolyuria

Patients who are polydipsic secondary to hypovolemic hypernatremia are not polyuric.Thirstcauses the ingestion of water, while ADH functions to conserve it. IfADH is present, theingested water will not be excreted.Many patients complain of increased urination, often referring to urinary frequency or ur-gency such as that seen in urinary tract infection. In this chapter, the term

polyuria

refersspecifically to increased urine

volume