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24-hour urine volumes have some changes even under normal circumstances and the daily urinary output is closely related to foods, environment temperature, age, mental factors and exercises, etc.
Generally speaking, the 24-hour urine output is between 1500-2000 ml and the urinary volume between daytime and night is about 2-4:1. It is called diuresis if daily urine exceeds 2500ml.
In case of PKD, patients usually have high volume of urinary output and frequent night urination. This is because the renal concentrating function has been damaged.
PKD patients usually will have normal kidney functions until 40-60 years. Once renal functions begin to decline, the decrease rate of GFR every year will be about 4.4-5.5ml/min and it takes about 10 years to develop into end stage renal disease if no treatment is received.
Decreased renal concentrating function is often the early sign of declined renal functions because it is the renal tubules that are first damaged than glomeruli in PKD. The symptoms of this stage is higher than normal urinary output especially increased night urination.
The basic functional and structural unit of kidney is nephron which consists of renal corpuscle and renal tubule. Renal tubules have the function of secretion and re-absorption functions and it can be divided into 3 parts---proximal tubule, distal tubule and medullary loop. Medullary loop mainly assume the function of urine concentration and dysfunction in urine concentration will cause increased urine output, low ooze or isotonic urine.
Increased volume of urinary output often indicates that renal functions begin to be affected by these renal cysts of PKD, therefore proper and timely treatments should be received to slow down or reverse renal damages.
Symptomatic treatment is mainly the use of antidiuretic hormone which can affect re-absorption of water by changing the permeability of the epithelial cells in distal and collecting tubules and improve urine concentration functions as as to reduce urine output.
Besides antidiuretic hormone, patients must seek more effective treatments to protect renal functions from further damages. Some herbal medicines can have overall shrinking effects on cysts of all sizes and slow down their growth rate. Though PKD can not be cured at present, herbal medicines can delay the progression rate and strive more time for more effective treatments.
