Las causas de la nocturia.

La nocturia o levantarse varias veces por la noche a orinar puede obedecer a muchas causas:
La poliuria global se caracteriza por la producción de cantidades excesivas de orina tanto de día como de noche, lo que lleva a un incremento de la diuresis; una de las principales enfermedades causante es la diabetes.

La poliuria nocturna se produce cuando se orina más del 33% de la proporción de orina de 24 horas durante la noche. Las causas se suelen deber a alteraciones de unas hormonas específicas que regulan el metabolismo del agua como sucede en la insuficiencia cardiaca congestiva, la apnea obstructiva del sueño, la enfermedad renal crónica, la insuficiencia venosa de las piernas, la toma de diuréticos o la ingesta exagerada de líquidos antes de acostarse.
Las enfermedades del tracto urinario inferior como es la hiperplasia benigna de próstata en la que la vejiga pierde la capacidad de retener líquidos producen nocturia. También las infecciones de orina o la inflamación de la vejiga como se produce tras la radioterapia pueden causar este síntoma.

Las alteraciones del sueño son otra de las principales causas para levantarse con mayor frecuencia por la noche.
En la realización de la historia clínica, es fundamental hacer un diario miccional para evaluar el grado de nocturia. En los hombres, siempre hay que evaluar la sintomatología prostática y en la mayoría de los pacientes descartar un problema de corazón, alteraciones del sueño, diabetes, tipo de medicación e ingesta de líquidos.

El tratamiento de la nocturia es complejo y debe orientarse a las causas que la producen. Levantarse a orinar varias veces por la noche no es normal y no se debe atribuir simplemente a un problema de la edad o de la vejiga por lo que siempre hay que investigar las causas.

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