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PubMed2000

[Possible mechanisms of polyuria in progressive chronic renal failure].

AIM: Elucidation of the role of saluresis and osmotic diuresis in renal function of patients with chronic renal failure. MATERIAL AND METHODS: The trial included 68 subjects, among them 25 patients with chronic renal failure (CRF) of the third and fourth degree aged 16 to 72 years. Enzyme immunoassay was used to measure osmolality, sodium, potassium, magnesium, calcium and creatinine concentrations in the serum and urine as well as urine prostaglandin E2. RESULTS: Renal function was studied in CRF patients with a 75-90% fall of glomerular filtration rate. Creatinine clearance was 19.9 +/- 0.96, it varied in different patients from 10.6 to 29.7 ml/min. It is shown that diuresis does not correlate with the total ion excretion (Na+ plus K+)(r = 0.946, p < 0.0001). A correlation was found between excretion of these ions and Mg2+ ions this indicating location of reabsorption reduction in the thick ascending limb of Henle loop. In CRF patients (Na+ plus K+) excretion correlated with PGE2 excretion (r = 0.65, p < 0.0001). CONCLUSION: It is suggested that at this stage of chronic renal failure the mechanism of a diuresis increase is not due to osmotic diuresis but rather to secretion of prostaglandin E2 which inhibits cation reabsorption and stimulates diuresis. Differences are considered between osmotic diuresis and different types of saluresis; their possible mechanisms are discussed.

Adolescent↗
PubMed2002

[Nocturia and nocturnal polyuria in the elderly. Treatment essential for increasing patients' quality of life and decreasing the risk of injury].

Nocturia, i.e. nocturnal voiding episodes, is a symptom which can occur at all ages, but there is an age-related increase in both men and women. Both health and quality of life are deteriorated by nocturia. Sleep is disturbed, with daytime sleepiness and reduced well-being as consequences. The risk of fall injuries is increased among elderly persons who need to get up several times at night for toilet visits. Nocturia is associated with an increase in nocturnal urine output, and an increased number of nocturnal voids indicates a shift of urine output from the daytime to the night. One of the aims of the treatment of nocturia is therefore to normalise the circadian rhythm of diuresis.

Aged↗