DIURESIS

Diuresis is an increase in the production of urine by the kidneys, which typically results in a corresponding increase in urine expelled by the body. When it happens without an accompanying increase of urination can cause severe medical problems. It has a wide range of causes and an assortment of treatment approaches, when treatment is required.

Certain types of exercise can cause diuresis, and it can also be caused by a wide range of health conditions and the use of certain drugs or medications. Coffee is an example of a well-known diuretic drug, but many other substances can lead to increased urine production as well. The condition can also be caused by polydipsia, another way of saying intense thirst, as most people respond to thirst by drinking more, stimulating an accompanying increase in urination.

Diuresis is not necessarily cause for concern, depending on the root cause. For example, people at high altitude look for signs of diuresis to indicate that they are adapting well to the conditions at altitude, and it is also a common side effect of some prescription drugs. In these circumstances, people may be aware that they need to look out for diuresis, but it isn’t cause to run to see a medical professional. For patients recovering from renal failure, increased urine production is often a welcome sign, indicating that the kidney function has radically improved.

In other instances, diuresis is a sign of a serious problem. It can indicate that the kidneys are malfunctioning, for example, and it is a common associated symptom of conditions like heart failure, diabetes, hypercalcemia, and an assortment of other conditions. In these instances, it is important for a person to see a healthcare professional to get to the root cause of the increased urine and to address it as needed. An assortment of anti-diuretic drugs can be administered, and treatment for the underlying condition is also strongly recommended.

There are several different types of diuresis, and it can be important to identify which type a patient is suffering from. In osmotic diuresis, for example, substances build up in the tubules of the kidneys, interfering with the re absorption of water and causing an elevated level of water in the bloodstream, which in turn causes the kidneys to increase urine output. In rebound diuresis, patients produce a large amount of urine as they recover from renal failure. It can also be caused by exposure to cold or prolonged submersion, in which case it is known as immersion diuresis, as the body constricts blood vessels to conserve heat, leading the kidneys to produce more urine.

Osmotic diuretics are a class of medications that cause patients to have increased urine production. These drugs work by shifting the balance of water between different parts of the body. The different osmotic diuretics include mannitol, isosorbide, urea, and glycerin. In general these medications have a less potent effect compared to some of the other types of diuretics. Although these medications are typically well tolerated, patients with certain underlying diseases should not take them. The mechanism of action of osmotic diuretics is to alter how the kidney filters the blood and produces urine. In general, osmotic agents exert their effects because their presence increases the amount of substances dissolved in the blood. With high concentrations of osmotic agents in the body, water will flow from inside the cells and into the bloodstream in an effort to normalize the relative concentration of substances in the intracellular and extracellular spaces in the body. This results in more fluid going to the kidney to be filtered, causing increased urine production.

Additionally, the presence of osmotic agents in the fluid being filtered by the kidney can result in less water being reabsorbed into the bloodstream, resulting in increased urination. There are four different osmotic diuretics that are typically used. One of the most important is a chemical species called mannitol, which is a small molecule that is not digested and does not participate in any chemical reactions within the body. The other two commonly used agents include glycerin and isosorbide. Urea, another osmotic diuretic, is not used in the U.S. but can be prescribed in other countries around the world. Overall, the osmotic diuretics are considered to be less potent medicines compared to some of the other classes of diuretics. They cause patients to urinate less as compared to some of the other diuretics. Therefore, while they are sometimes used solely to increase urine output, they are also used in a few other ways. For example, mannitol can be given to patients who have an increased intracranial pressure in an effort to decrease this pressure by causing some of the fluid in the brain to flow into the bloodstream.

Common side effects of the osmotic diuretics can include headache, vomiting, and nausea. Prolonged use of the medication could decrease the concentration of sodium in the blood, leading to a condition called hyponatremia. When mild, this condition causes non-specific symptoms; severe hyponatremia can cause seizures, however.Not all patients should be given osmotic diuretics. Giving osmotic diuretics increases the volume of blood circulating around the body. In patients who already have too much fluid in their bodies, for example in patients with end-stage kidney disease or congestive heart failure, the medications should not be given because they could worsen the ramifications of these underlying disease processes. Patients who do not produce urine should also not be given the medications.