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Clinical Pediatrics, Vol. 30, No. 11, 634-640 (1991)
DOI: 10.1177/000992289103001104

Polyuria in Childhood

Alexander K.C. Leung, MBBS, FRCPC, FRCPI, FRCP(Glasg), FRCP(Edin)

Alberta Children's Hospital, 1820 Richmond Road SW, Calgary, Alberta, Canada T2T 5C

Wm. Lane M. Robson, MD, FRCPC

Department of Pediatrics, the University of Calgary

Mitchell L. Halperin, MD, FRCPC

Department of Medicine, the University of Toronto

Polyuria may result from either a water or a solute diuresis. Although the history and physical examination may provide clues to the cause of the polyuria, the definitive diagnosis requires laboratory tests which focus on the osmolality of the urine and serum in combination with the urine volume and the rate of excretion of osmoles. An isoosmolar or hyperosmolar urine is found in children with a solute diuresis or in normal children, whereas a hypoosmolar urine is found in children with a water diuresis. In the latter case, a low serum osmolality suggests primary polydipsia whereas a high serum osmolality suggests antidiuretic hormone (ADH) deficiency or insensitivity. A water deprivation test is necessary when the initial evaluation fails to establish the cause of polyuria. A vasopressin test enables the differentiation between neurogenic and nephrogenic diabetes insipidus (DI).


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