Nocturnal Polyuria Differential Diagnosis

The differential diagnosis for nocturnal polyuria can be organized into the following categories:

• Single Most Likely Diagnosis
  • Benign Prostatic Hyperplasia (BPH): This condition is common in older men and can cause urinary frequency, urgency, and nocturia due to bladder outlet obstruction.
• Other Likely Diagnoses
  • Diabetes Mellitus: Uncontrolled diabetes can lead to polyuria, including nocturnal polyuria, due to hyperglycemia-induced osmotic diuresis.
  • Sleep Apnea: This condition can cause increased urine production at night due to changes in intrathoracic pressure and increased atrial natriuretic peptide secretion.
  • Chronic Kidney Disease: Reduced renal concentrating ability can lead to nocturnal polyuria.
  • Overactive Bladder: This condition can cause urinary frequency, urgency, and nocturia due to detrusor muscle overactivity.
• Do Not Miss Diagnoses
  • Heart Failure: Congestive heart failure can cause nocturnal polyuria due to increased fluid redistribution and atrial natriuretic peptide secretion.
  • Diuretic Use: Certain diuretics, such as loop and thiazide diuretics, can cause nocturnal polyuria as a side effect.
  • Pheochromocytoma: This rare tumor can cause nocturnal polyuria due to excess catecholamine production leading to increased renal blood flow and sodium excretion.
• Rare Diagnoses
  • Nephrogenic Diabetes Insipidus: A rare condition characterized by impaired renal concentrating ability, leading to polyuria.
  • Central Diabetes Insipidus: A rare condition caused by deficiency of antidiuretic hormone (ADH), leading to polyuria.
  • Nocturnal Polyuria due to Psychogenic Causes: Certain psychiatric conditions, such as anxiety or depression, can contribute to nocturnal polyuria.