Rationale

Although not common, polyuria and/or polydipsia may be the presenting symptom(s) of a potentially serious underlying condition. It may be confused with urinary frequency, a common complaint.

Causal Conditions

(list not exhaustive)

1. Water diuresis

   1. Excessive intake

   2. Excessive loss – diabetes insipidus

2. Osmotic diuresis

   1. Sugar – diabetes mellitus

   2. Urea – chronic renal disease

   3. Salts – organic anions

Key Objectives

Given a patient who presents with polyuria and/or polydipsia, the candidate will diagnose the cause, severity, and complications, and will initiate an appropriate management plan.

Enabling objectives

Given a patient with polyuria and/or polydipsia, the candidate will

1. list and interpret critical clinical findings, including

   1. diagnose polyuria/polydipsia, causal factors, and severity, differentiating urinary frequency from polyuria;

   2. inquire about any personal or family history of diabetes;

   3. identify neurological features that may suggest intracranial pathology as a cause of central diabetes insipidus;

2. list and interpret critical investigations, including

   1. tests which distinguish between water and osmotic diuresis;

   2. screening for diabetes;

   3. use of a voiding diary, when appropriate;

3. construct an effective initial management plan, including

   1. management of the underlying cause;

   2. determination as to whether the patient requires specialized care.