Corticosteroid-Induced Polyuria
Corticosteroids can cause increased urination (polyuria), most often through steroid-induced hyperglycemia leading to osmotic diuresis. [1]
Mechanism of Polyuria With Glucocorticoids
Glucocorticoids can induce diabetes mellitus or worsen existing diabetes by increasing blood glucose. [1] Sustained hyperglycemia can cause glycosuria. [1] Glucosuria can produce osmotic diuresis that increases urine volume and causes polyuria. [1]
Reported Clinical Evidence
Steroid-induced diabetes mellitus is a recognized complication of glucocorticoid exposure. [1] A published case report described glucocorticoid-associated polyuria that was resistant to vasopressin, consistent with a mechanism beyond typical diabetes mellitus alone. [2]
When Polyuria Suggests Steroid-Related Hyperglycemia
Polyuria occurring after starting or increasing glucocorticoid therapy should raise concern for steroid-induced diabetes with osmotic diuresis. [1] The presence of polydipsia commonly accompanies osmotic diuresis from hyperglycemia. [1]
Evaluation and Monitoring
Serum glucose testing is appropriate when polyuria develops during corticosteroid therapy. [1] Urinalysis for glycosuria supports osmotic diuresis from hyperglycemia. [1]
When Urgent Assessment Is Needed
Urgent evaluation is indicated when polyuria is accompanied by symptoms consistent with severe hyperglycemia or dehydration (for example, marked thirst, weakness, vomiting, or altered mental status), because complications of diabetes can develop with steroid exposure. [1]