Differential Diagnosis for 71-year-old Male with Urinary Frequency and Low Volume Urine
- Single most likely diagnosis:
- Diuretic effect of Jardiance (Empagliflozin): The patient started Jardiance, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, last week. This medication is known to increase urinary glucose excretion, leading to an osmotic diuretic effect, which can cause urinary frequency and low volume urine.
- Other Likely diagnoses:
- Benign Prostatic Hyperplasia (BPH): A common condition in older males, BPH can cause urinary frequency, urgency, and decreased urine flow due to prostate enlargement.
- Overactive Bladder: This condition can cause urinary frequency, urgency, and nocturia, often without any underlying urinary tract infection or other obvious cause.
- Dehydration: Inadequate fluid intake or excessive fluid loss can lead to low volume urine and frequency.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Urinary Retention: Although the patient has urinary frequency, it's essential to rule out urinary retention, especially in older males with possible BPH, as it can lead to serious complications like kidney damage if left untreated.
- Diabetic Ketoacidosis (DKA): Although the patient is on Jardiance, which is used to treat type 2 diabetes, it's crucial to consider DKA, especially if the patient has a history of diabetes, as SGLT2 inhibitors can increase the risk of DKA.
- Post-Renal Acute Kidney Injury (AKI): Any condition causing obstruction of urine flow, such as kidney stones or bladder outlet obstruction, can lead to post-renal AKI, which is a medical emergency.
- Rare diagnoses:
- Interstitial Cystitis: A chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain, which can lead to urinary frequency and urgency.
- Bladder Cancer: Although rare, bladder cancer can cause urinary frequency, urgency, and hematuria (although the patient's UA is negative).