Great video, I would add an emphasis on another form of osmotic diuresis and that being from urea nitrogen in the setting of high protein intake. Not uncommon, young healthy men during bulking season will try to consume >2g/kg of protein thinking this protein goes to their muscle. A large part of that is converted into nitrogen containing compounds that they just pee out. Yes, you're peeing out that 16oz steak and chicken breast. Good way to know this is occuring is history and looking at their osm free water clearance and electrolyte free water clearance. These are usually discordant to a significant degree. Also, if someone has primary polydipsia for a prolonged period of time, they can wash out their medullary interstitium and respond to water deprivation like someone with partial nephrogenic DI due to gradient disruption.
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@@StrongMed Thanks! And why "Nocturia and Polyuria don't coexist"? according to your Venn diagram. Can't polyuria also occur at night, waking up and go?
Nocturia is urinary frequency that occurs predominantly or even solely at night. For a patient to have both polyuria and nocturia, they would need to hold 1-2L of urine in their bladder all day long, and then only release it in the nighttime. I suppose someone could deliberately induce this pharmacologically (i.e. taking a bunch of diuretics only at bedtime), or maybe if a person with a "natural" reasons for polyuria (e.g. severe hyperglycemia, diabetes insipidus) took an anticholinergic drug only in the morning that had a prominent side effect of urinary retention. But it's hard to imagine a natural process that would result in this.
Thanks for the suggestion! It's now on my list, but as it's a less common chief complaint / chief symptom, I'll probably get to it a bit later than some of the others.
