Many diseases can manifest as polyuria and polydipsia. Firstly, it should be clarified whether the urinary osmolality is high or low. For low urinary osmolality, attention should be paid to the differential diagnosis of uremia and psychogenic polydipsia, with high blood osmolality in the former and low blood osmolality in the latter.
If uremia is considered, attention should be paid to the differential diagnosis of central uremia, renal uremia, primary and secondary uremia. If urine osmolality is high, attention should be paid to the differential diagnosis of osmotic diuresis such as diabetes mellitus, low potassium and high calcium.
To differentiate these diseases, routine urine, blood urine osmolality, liver and kidney function, blood glucose, blood electrolytes, 24-hour urine electrolytes, and if necessary, water-suppression test should be performed, and if the diagnosis of central uremia is made, cranial MRI should be performed to further clarify the etiology.
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