Post Date December, 03 2023
When the 24-hour urine output exceeds 400 milliliters, it enters the polyuria phase, indicating that the renal parenchyma begins to repair. The polyuria stage is divided into two stages, from the 24-hour urine output exceeding 400 milliliters to the beginning of a decrease in blood non protein nitrogen, and then to the early stage of polyuria.
Due to poor recovery of renal function, less solute excretion, and less water resorption during this period, the changes in blood chemistry not only did not improve, but sometimes the concentration of non protein nitrogen in the blood actually increased. Therefore, the treatment is basically the same as in oliguria. From the beginning of a decrease in non protein nitrogen to the normal value, it is the late stage of polyuria. During this period, the patient's general condition gradually improves and their appetite increases. However, due to the large loss of water and electrolytes, if not replenished in a timely manner, it can also bring a series of complications. Therefore, the treatment for this period mainly includes:
1. Maintain water balance: During the oliguria period, patients are mostly in a state of excessive water with different procedures. Therefore, with the arrival of the oliguria period, they are allowed to discharge excess water on their own to achieve a new balance. Liquid supplementation should be based on 1/3 to 2/3 of urine volume. If the same amount is added to urine volume, it will prolong the polyuria period.
2. Maintain electrolyte balance: With the discharge of water, there will be a significant loss of electrolytes, so it is necessary to replenish them in a timely manner. Generally, 500 milliliters of physiological saline should be added per liter of urine, and potassium salt should be supplemented as appropriate when the 24-hour urine volume exceeds 1500 milliliters.
3. Prevention and treatment of infection: Patients in this stage are often very weak, with extremely low resistance, and are prone to infection. Therefore, active prevention and treatment are necessary.
4. Strengthen nutrition: Gradually increase the intake of high-quality protein, and severe anemia can be treated with blood transfusions.
