What is the normal daily diuresis in adults? Is it good to drink.
People, especially those suffering from frequent urination, may wonder how many times a day an adult should write (urinate) and whether there is any norm or volume in this regard. Let's try to answer these questions.
First, a little about the urine itself. This is a biologically active fluid that is produced by the kidneys, excreted and descends through the ureter down to the bladder and urethra. Together with urine, the body removes the end products of metabolism. If the body becomes ill, pathological metabolic products, as well as drugs and foreign substances, begin to be excreted in the urine.
The process of urination in a completely healthy person, it occurs freely, painlessly and without any effort. After the completion of urination, a person has a pleasant feeling of complete emptying of the bladder. If there is pain during urination or the process goes on with effort, these are signs of an inflammatory process in the urinary system. In this case, urgent treatment is required.
The amount of urine produced
Fine per day in an adult can vary from 800 to 1500 ml, depending on age and other factors. The entire volume of urine excreted by a person per day is called daily diuresis. A healthy adult urinates 4-7 times a day and no more than 1 time per night. Daytime and nighttime diuresis correlate within 3 to 1 or 4 to 1. Each portion of urine averages 200-300 ml, sometimes up to 600 ml (usually the largest amount is in a portion of morning urine after waking up). If more than 2000 ml or less than 200 ml was released per day, this is already considered a pathological amount.
The total amount of urine per day depends on several factors.: age, fluids drunk, including soups, compotes, etc., from the presence of diarrhea, the amount of sweat released (urine excretion noticeably decreases with increased sweating of a person), from body temperature, from water loss by the lungs and other factors.
It is important for a sick person to know- what is the total amount of urine excreted in one day and what is its ratio with the liquid taken during this time. This is the water balance. If the amount of fluid consumed far exceeds the amount of urine excreted and is accompanied by an increase in the patient's weight, then there is reason to believe that the patient has. If a person excretes more urine than drinks liquids, then this means that there is a diuretic effect from the drugs or herbal infusions taken. In the first case, this is called negative diuresis, in the second - positive.
The human body is almost 60% water. This is so important for the normal functioning of the body that the loss of only 1.5% of the fluid already leads to the most unpleasant consequences. Problems associated with a lack of water can overtake a perfectly healthy person if, for example, he spends several hours under the scorching sun without taking a drink with him, but in this case it is very easy to correct your well-being. It is much more difficult to minimize the effects of dehydration if it occurred for other reasons. We will consider the most frequent of them in the article.
Diabetes
When the absorption of sugars fails, the concentration of glucose in the blood becomes too high. The body tries to normalize its amount by increasing excretion in the urine. A patient who is constantly thirsty absorbs liquid intensely, which further activates this process. An unreasonable load is created on the kidneys. The cells of the body, deprived of the required amount of fluid, begin to take it from the bloodstream, which causes further "saccharification" and thickening of the blood. There is a so-called vicious circle of dehydration, which is fraught with the most sad consequences, up to the rapid death of the patient.
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PMS in women
In the period preceding menstruation, a woman's hormonal background changes, which leads to a decrease in the water content in the cells of the body. Fluctuations in progesterone and estrogen in the blood play an important role here. Then monthly bleeding begins, and water loss can be quite significant. Women are encouraged to drink plenty of fluids during this time, especially in the form of soothing herbal teas. They help to avoid dehydration, while relieving excessive muscle tone and reducing menstrual pain.
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In the initial stages of gestation, women are often tormented by toxicosis, one of the signs of which is nausea or vomiting. If such episodes are repeated frequently, the body may lose a significant amount of water. In addition, many pregnant women limit themselves to fluid intake, fearing the appearance of edema. Meanwhile, the body of the expectant mother is in dire need of an increase in blood volume, and hence in additional water.
Dehydration of a pregnant woman's body can lead not only to a deterioration in her well-being and damage to the cardiovascular or excretory system, but also to such consequences as the formation of malformations in a baby or a miscarriage.
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A nursing mother loses a substantial amount of fluid with milk every day. If the lack of water in the body is not actively replenished, she will have health problems. That is why women are advised to drink more water, tea, milk, fruit juices and compotes during this period. This saves the body from dehydration, enhances lactation and improves the composition of breast milk.
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Medication
The action of most drugs intended to lower blood pressure and treat pathologies of the kidneys and urinary tract is based on a diuretic effect. The ability to increase diuresis is possessed by many medicinal plants traditionally used in folk medicine: berries of lingonberries and cranberries, herb knotweed and shepherd's purse, birch buds, etc.
Patients who suffer from hypertension, cystitis, impaired renal function, edema, etc., should be warned about the need to increase the amount of fluid consumed. Otherwise, they may develop dehydration while taking medications.
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Glucose, which the body could not use in time, accumulates in the tissues in the form of glycogen. Each molecule of this substance binds three molecules of water. When a person drastically reduces carbohydrate intake, his body begins to use up reserves, losing fluid. By the way, it is the loss of glycogen-bound water that explains the rapid weight loss that occurs in the initial stages of low-carbohydrate diets.
If the restriction of carbohydrate intake continues for more than a week, dehydration adversely affects the skin, nervous system and general condition of the body. It is especially harmful to exclude rice, oatmeal and durum wheat pasta from the diet: during the cooking process, they absorb water and, in addition to many useful substances, supply the body with fluid.
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At the time of physical or nervous overstrain, aldosterone is produced in the body - the hormone of the adrenal glands, which takes an active part in the normalization of water and electrolyte balance. Prolonged stress depletes this function, aldosterone production decreases and the body loses fluid.
Only the elimination of stress as the cause of the problem can help. Increased fluid intake in this situation gives only a weak and temporary effect.
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About 20% of people suffer from this disease. The risk of dehydration for such patients is very high: many of them have frequent bouts of diarrhea as the main symptom of the disease. In addition, most patients, fearing the appearance of unpleasant symptoms, exclude from their diet a number of foods, the consumption of which increases the water content in the body.
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Sports activities improve the figure and mood, increase immunity and vitality, but can be harmful to health if approached without due care. In particular, it must be taken into account that in the process of training the body loses a lot of water through sweat. Therefore, it is important not only to dose physical activity, but also to replenish fluid deficiency in time.
To do this correctly, it is enough to regularly weigh yourself before and after training. For every kilogram of weight lost during exercise, you should drink from 500 to 750 ml of water (preferably mineral), fruit decoction or herbal tea. Drinking this amount should minimize the risk of dehydration.
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With age, the likelihood of dehydration increases. The hormonal background changes, tissues gradually lose their ability to retain moisture. Many older people experience a decrease in fluid intake due to the fact that they are less likely to feel thirsty. In such cases, experts recommend drinking water regularly at regular intervals and monitoring the amount of fluid that has entered the body during the day. This helps to maintain the necessary level of tissue hydration.
Urine is formed in the kidneys, which, as you know, are the body's filter, removing everything bad from the blood (germs, toxic substances, etc.).
If urine acquires an unhealthy shade or becomes very small, then this is a signal to pay close attention to the functioning of the excretory system.
The amount of urine: the norm and deviations from it
On average, a person should excrete about 1.5-2 liters of urine per day. Of course, this indicator will vary in each individual case. In particular, a lot will depend on how much liquid a person drinks.
Why does a person write little? The reasons may be the following:
- The person drinks few liquids. Every day you need to drink at least 1-1.5, and for some, 2 liters of water.
- The person sweats profusely. For example, this situation may occur in hot weather.
If the deviations from the norm are not too significant, then just try to drink more and try to eliminate the factors that provoke profuse sweating (for example, do not drink hot tea in summer, stay in a cool place on especially hot days, wear light "breathable" clothes, etc. .)
In addition to the more or less harmless causes that we listed above, there are also various diseases that cause a lack of urine or its excess:
- kidney failure;
- pathology of the renal vessels;
- blood diseases;
- acute pyelonephritis;
- embolism of the veins of the kidneys;
- glomerulonephritis, etc.
Therefore, if the amount of urine is significantly less / more (oliguria / polyuria) than the amount of fluid drunk per day (especially if less than 500-200 ml of urine is excreted per day), then you need to urgently consult a doctor. There are also situations when urine does not leave at all (anuria) - this is an even more severe case of the disease, requiring immediate medical attention.
Color and clarity of urine
In parallel, you need to monitor the external indicators of urine - they will also be able to tell about the problems that have arisen in the body.
- It is easy to check the level of transparency: collect urine in a jar and look through the liquid at some text. If you can read it, then the transparency is normal, if not, then it is better to consult a doctor.
- Pink urine can indicate kidney disease, but it can also appear after eating beets / raspberries / blackberries and dishes with them, or if a woman is having her period.
- An orange/brownish hue appears, for example, due to an increase in the concentration of urine. It occurs with oliguria. This shade can also give food coloring, beets, carrots and the berries mentioned above, legumes. Finally, medications, such as antibiotics, can give an orange tint. If the urine has a brownish tint, and the stool is light, then a violation in the liver can be assumed.
- The color of meat slops in urine occurs with glomerulonephritis, cancerous pathologies. If urine has acquired this color only once, then you should definitely consult a doctor so as not to miss a serious illness.
- A greenish-blue tint occurs, but is very rare. Occurs with metabolic disorders, infectious diseases.
Prevention of kidney disease
The most effective and easiest way to avoid many kidney diseases is to drink at least 1.5-2 liters of ordinary pure non-carbonated water per day. It is plain water, not tea, coffee, juice, compotes, etc.
Studies have shown that in all regions where they were introduced, their consumption has decreased. Moreover, restrictions in the evening hours were more effective than in the morning. Another regularity has been revealed: the softer the restrictions, the higher the consumption. Interestingly, contrary to stereotypes, the restrictions had virtually no effect on the increase in the consumption of moonshine. On the contrary, in the regions where the framework was introduced, this indicator even slightly decreased. Experts explain this by the fact that in this situation the concept of unacceptability operates. It doesn't matter what kind of alcohol restriction applies, what matters is that it exists. And with this framework, the region emphasizes that drinking all day is unacceptable.
However, as statistics show, with prohibitions and restrictions, those who did not do it regularly, but from time to time, stop drinking in the first place.
What is the norm?
No one, including the World Health Organization, calls for absolute abandonment of alcohol. You can drink, but within reasonable limits. Moreover, the concept of "reasonable consumption" is not subjective, but quite objective and countable. For men, reasonable consumption means taking no more than 168 g in terms of pure alcohol per week, for women the norm, naturally, is less - up to 112 g. I. I. Mechnikova, Doctor of Medical Sciences Svyatoslav Plavinsky. - When it comes to them, many do not take into account, for example,. Meanwhile, do not forget that this is also alcohol, and, for example, 2 liters of beer is a lot!
There is a whole gradation that allows, depending on the doses, to determine the degree of alcohol dependence (see table).
| Table | ||
|---|---|---|
| Consumption (in terms of pure alcohol), g per week | Men | Women |
| Reasonable | up to 168 | up to 112 |
| Harmful | 168-224 | 112-168 |
| dangerous | 224-392 | 168-280 |
| Risky | over 392 | over 280 |
Difficult questions
It is clear that those who fall into the risky category know everything about themselves, and everything is clear with their relatives. But the previous groups do not yet need the help of a narcologist, but they need competent recommendations from a doctor who will indicate how this dose of alcohol affects their health at the moment.
However, a simple statement of fact: you have a problem with alcohol - is unlikely to be effective. A person needs to be led to understand this. According to Svyatoslav Plavinsky, alcohol abusers most often end up at the appointment ... with a dermatologist, since alcohol first of all affects the condition of the skin. “If the doctor at the reception says: “You have microbial eczema, but do you know why? Because you drink a lot, "- it will be much more effective," the expert is sure.
From June 1 of this year, every doctor is required to ask the patient if he smokes. And if he gives a positive answer, give him recommendations on how to cope with this addiction. Experts are convinced that the same should be done in the case of alcohol. To help doctors, special tests and questionnaires are being developed to identify problematic alcohol consumption. True, it is not yet clear what a doctor can do if the patient does not want to take into account his recommendations.
“In the West, a doctor will not prescribe a person who has problems with alcohol to work, even if the person applied for a cold,” says Sergey Boyarsky, Associate Professor of the Department of Health Management and Economics at the Higher School of Economics, Candidate of Medical Sciences. - First he will have to undergo a course of treatment. We do not have mandatory medical care.”
It is interesting that the researchers offer the doctor to become almost a philosopher, helping the drinking patient find answers to sacramental questions: why do I drink and why should I not drink. There will be an answer - there will be motivation not to drink or drink, but not much.
Daily diuresis is one of the criteria for the proper functioning of the kidneys. Urine excreted per day is usually considered. Normally, in an adult, the amount of urine excreted is ¾ or 70-80% of the fluid consumed. At the same time, the amount of moisture that enters the body along with food is not taken into account. Therefore, if a person has to drink about two liters of fluid per day, then the volume of urine excreted is at least 1500 ml.
In order to completely remove decay products from the body, at least half a liter of urine must be excreted. Determination of daily diuresis is also important for the study of kidney function by the method of calculating clearance. To do this, the patient must collect all urine during the day in a special container with graduated walls.
However, he should not take diuretics during the procedure and three days before it. It is also important to record not only the volume of urine excreted, but also the volume of fluids drunk (water, tea, coffee). Measurement of daily diuresis usually starts from 6 am until the same time the next day.
Depending on the amount of urine excreted, there are:
- polyuria - the amount of excreted fluid exceeds 3 liters. This may be due to a disruption in the production of the hormone vasopressin, also called antidiuretic hormone. Sometimes this condition occurs in violation of the concentration ability of the kidneys, with diabetes;
- oliguria - the amount of fluid secreted has sharply decreased to 500 ml or less;
- anuria, in which urination in an adult does not exceed 50 ml in all 24 hours.
Urination throughout the day is uneven. Therefore, daytime and nighttime diuresis are distinguished, the ratio of which is normally 4:1 or 3:1. If nocturnal diuresis prevails over daytime, then this condition is called nocturia.
It is also important for patients to evaluate not only the amount of fluid released, but also its composition. If the concentration of osmotically active substances in the urine exceeds the norm, then such diuresis is called osmotic. This condition indicates an overload of nephrons with substances such as glucose, uric acid, bicarbonate and others. Their increase in the blood is associated with another organic pathology.
The daily amount of urine with a reduced concentration of osmotically active substances is called water diuresis. In a healthy person, this condition can be observed with an increase in fluid intake.
Decreased urine output
A decrease in the daily amount of urine in a healthy person can be observed in the hot season, when most of the fluid is excreted with sweat. Also, this condition occurs when working in conditions of high temperatures, loose stools or vomiting.
But a decrease in urination to 500 ml per day or less is a poor prognostic sign for many diseases. The development of oliguria or anuria occurs with a sharp decrease in circulating blood volume and a drop in blood pressure. They develop with heavy bleeding, indomitable vomiting, profuse loose stools, and various shock conditions.
Oliguria occurs with the development of acute renal failure. This life-threatening complication occurs with nephritis, acute massive hemolysis, and damage to the renal parenchyma. With a massive infectious process, kidney damage is possible with bacteremia.
Differential diagnosis of oliguria must be carried out with ischuria. This condition develops due to mechanical blockage of any part of the urinary system. This can lead to the growth of the tumor process, blockage of the lumen of the ureter with a stone, or narrowing of the urinary tract. In men, a common cause of ischuria is prostate adenoma, especially in older people.
Increase in the amount of urine produced
Polyuria is an important diagnostic criterion for a number of endocrine, cardiac or metabolic diseases.
Distinguish between renal and extrarenal polyuria. The first is caused directly by kidney disease, in which the distal nephron is affected. Such a symptom can occur with pyelonephritis, wrinkled kidney, renal failure. 
There are many more reasons for the development of extrarenal polyuria. An increase in urine production occurs in diabetes mellitus. This occurs when glucose enters the urine, which pulls the liquid onto itself, since it is an osmotically active substance.
In diabetes insipidus, the genesis of polyuria is a violation of the production of vasopressin, which is responsible for the retention of the required amount of fluid. Daily diuresis also increases with Conn's syndrome (hyperaldosteronism).
Also, extrarenal polyuria occurs with an increase in fluid in the vascular bed. For example, with intravenous drip of solutions with diuretics, that is, forced diuresis. The doctor prescribes diuretic drugs to reduce swelling. Excess fluid from the tissues returns to the bloodstream, and its excess is excreted along with the urine.
Urination during pregnancy
A change in the amount of daily urine is prescribed when there is a suspicion of the presence of latent edema or the threat of developing preeclampsia or eclampsia. Pregnant women are prescribed daily diuresis according to indications, the analysis is not included in the list of mandatory for expectant mothers.
