82. Urine amount qualitative and quantitative changings.

Diuresis – urine releasing for the time unit. One can differentiate several diuresis types:

• for 24 hours;

• daily (from 9.00 till 21.00);

• night or nocturnal (from 21.00 till 9.00);

• hour-long et al.

Daily diuresis correlation with night one is equal to 3:1. Urine quantity in morning portion is equal to 100…300 ml.

Anuria – (complete uroreleasing stoppage or when 24-houred diuresis is 0-100 ml):

• unreal or postrenal, or excretory – obstacle existence to uroreleasing due to urinary ways obturation with stones, tumors, particularly prostatic adenoma; prerenal unreal anuria is delt with renal circulation disorders for example due to heart-vascular insufficiency;

• real or secretory – kidneys uroreleasing injure due to acute renal insufficiency, hard acute glomerulonephritis forms.

Ishuria – uroreleasing lack when patient can not empty his urinary vesicle; this case can be observed particularly at spine injure, in unconscious state, at stress, problems in urinary vesicle, after surgical operations.

Nycturia – night diuresis dominance over daily one; it can be connected with enuresis, chronic renal insufficiency, heart activity disorders. Physiological nycturia can be present in children up to 3 years (term of ending spine lumbal and sacral parts maturation).

Pollakyuria – urination freaquening (more than 6 times in 24 hours). Usually it is accompanied by polyuria.

Dolakyuria – freaquent urination with small portions.

Dysuria – all urination disorders total designation.

Stranguria – painful urination.

Polyuria – state when urine quantity is more than 1800 ml/24 hour. Main reasons:

1. Liquids big quantities usage:

   • nervous excitement,

   • hypothalamus diseases.

2. Osmotic polyuria:

• diabetes mellitus;

• sodium chloridum excessive usage;

• aminoacids excessive usage;

• glucose excessive usage;

• urea excessive usage;

• mannite excessive usage;

• parenteral feeding;

• chronic renal insufficiency.

3. Diabetes unmellitus:

• central – hypophysis diseases;

• nephrogenic – kidneys diseases.

4. Nephropathy:

• after narcosis;

• pregnancy second half;

• after courses (cleanings, menstrual bleedings);

• primary alderosteronism;

• hyperparathyreoidism.

5. At oedemas liquidation:

• acute pyelonephritis;

• chronic renal insufficiency.

6. At diuretics taking.

7. Paraproteinaemias:

• amyloidosis;

• sarcoidosis;

• myelomic disease.

8. Renal artery stenosis.

9. Kidney transplantation.

10. Acute channel necrosis diuretic (polyuretic) phase.

11. Some drugs action results:

• caffeine;

• digitalis drugs;

• ethanol;

• acetylsalicylic acid;

• lithium;

• drugs with hypoglycaemic action.

Olyguria –urine 100-500 ml/24 hours:

1. Physiological:

• drinking regimen limit;

• excessive sweating in a hot weather.

2. Kidney diseases:

• nephrites;

• nephroses;

• inflammatory processes in renal parenchyma.

3. Enforced liquid loss:

• diarrhea;

• vomiting;

• bleeding;

• spread burnings;

• oedemas formation;

• abdomen traumas;

• intestinal obturation (impermeability).

4. Nephrotoxic substances action:

• Pb;

• As;

• Vi;

• ethylenglycol;

• drugs.

5. Urine outflow injure:

• stones;

• tumor and others.