Glucosuria

Normal urine contains small amounts of glucose, called basal glucosuria, and other carbohydrates.

Glucosuria results from the glomerular filtration of more glucose than the renal tubule can absorb. It occurs in all normal individuals in amounts up to 25 mg/dl. Abnormally increased glucosuria [more than 25 mg/dl in random fresh urine], results from either an elevated plasma glucose, an impaired renal glucose absorptive capacity, or both. Glucosuria leads to osmotic diuresis and dehydration.

Renal glucosuria is a rare condition in which the simple sugar glucose is eliminated (excreted) in the urine despite normal or low blood glucose levels.

Studies have demonstrated the mutations in the gene expressing SGLT2 transmembrane transporter responsible for most cases of renal glucosuria. These inhibitors are beneficial in reducing cardiovascular morbidity, mortality and the progression of diabetic renal. One of the proposed mechanisms underlying these cardiovascular beneficial effects is reduced weight and BP values.

In some cases, glucosuria may be pronounced enough to result in excessive urination (polyuria), excessive thirst (polydipsia), and other associated symptoms.
Glucosuria

Nephrogenic diabetes insipidus

Nephrogenic diabetes insipidus is characterized by renal resistance to the action of antidiuretic hormone (ADH) secretion.  The renal tube is unresponsive to ADH.

This disorder can be congenital or acquired. Genetic causes are less common but more severe than acquired forms of the disease, although genetic etiologies are more common in children than in adults.

Acquired causes of nephrogenic diabetes insipidus are more common. It may be caused by drugs such as lithium and demeclocycline, both of which are thought to interfere with vasopressin-stimulated cAMP generation or action.

In 85% of congenital diabetes insipidus, the disorder is inherited as an x-linked mutation.

Patients with nephrogenic diabetes insipidus usually have onset of symptoms in infancy, and present with recurrent episodes of dehydration, fever, failure to thrive and psychomotor retardation.

Patients with nephrogenic diabetes insipidus may develop severe dehydration of water is withheld for prolonged periods.
Nephrogenic diabetes insipidus