6/28 PPMC Report: Polyuria!

Today at PPMC we discussed the case of a 63 yo M with nephrogenic DI secondary to hypercalcemia from multiple myeloma — we REALLY covered some ground!

PEARLS for POLYURIA:
1. Use a mechanism driven approach to classifying Polyuria
Polyuria
2. In the office — a UDip and FSG can go a long way!
– Also think about Urine Osm, Serum Osm, BMP, TSH and UDS for intial work up. Don’t forget about a lithium level if appropriate!
3. The mechanism behind hypercalcemia causing polyuria is complicated (1) — but when elevated chronically it can cause a nephrogenic DI!
References:
1. Moeller HB, Rittig S, Fenton RA. Nephrogenic Diabetes Insipidus: Essential Insignts into the Molecular Background and Potential Therapies for Treatment. Endocr Rev. 2013 Apr; 34(2):278-301.
2. Sands JM, Bichet DG. Nephrogenic Diabetes Insipidus. Ann Intern Med. 2006;144:186-194.