Is frequent urination at night a red flag?

Waking up occasionally during the night to pass urine may not be a cause for concern, but when it becomes a bothersome symptom it should be evaluated. Nocturia, or frequent nighttime urination, is frequently underdiagnosed, particularly in older adults. But specialists say that this behaviour can be an early indicator of uncontrolled diabetes, BPH in men or overactive bladder in both genders particularly if it continues or worsens. Lifestyle disorders such as diabetes and hypertension are prevalent, and nocturia must be taken as a signal to watch more carefully for kidney health.

What Is Nocturia and Why Does It Occur?

Nocturia is waking up more than twice at night to urinate. Although it can be caused by habits such as excessive water intake before bedtime, or the intake of caffeine or alcohol in the late evening, it can also be a sign of something more serious. If kidney function is compromised, it can lead to increased urine production at night because the kidneys' decreased capacity to concentrate urine, particularly in the early phases of chronic kidney disease. Nocturia can also be a sign of uncontrolled diabetes or an obstructing prostate with over active bladder.

Symptoms and Signs That Can Indicate Kidney Issues

When frequent night time urination comes together with the following, it may indicate that a kidney problem is developing:

1. Leg, ankle, or facial swelling:
When kidneys are not effectively removing waste, fluid can accumulate in the body, particularly in the lower legs or eyelids.

2. Weakness and fatigue:
Toxic buildup in the body because of reduced kidney filtration may result in a constant feeling of tiredness or decreased stamina.

3. Unexplained hypertension:
Kidneys are important regulators of blood pressure. Dysfunction may result in consistently high readings.

4. Nausea, vomiting, or loss of appetite:
Waste products build up in the blood as kidney function decreases, resulting in gastrointestinal discomfort and loss of appetite.

5. Dry, itchy skin:
Imbalance in minerals and poor hydration caused by kidney problems can lead to persistent skin issues.

6. Difficulty concentrating or brain fog:
In advanced cases, toxin buildup can affect cognitive function, making it harder to focus or stay alert.


Tips to Protect Kidney Health

Here’s how to be proactive if you’re experiencing nocturia or are at risk of kidney disease:
• Restrict nighttime fluid intake, particularly of caffeine, tea, or alcohol, which will cause an increase in urine production.
• Monitor and control blood pressure and blood sugar since uncontrolled diabetes and high blood pressure are great risk factors for kidney damage.
• Eat a kidney-friendly diet; low in salt, sugar, and processed foods, and lots of fresh fruits such as papaya, apples and vegetables. Avoid coconut water and bananas and food high in Potassium
• Avoid pain relievers, such as NSAIDS or antibiotics unless prescribed by your doctor who is aware of the status of your kidney function and overall medical health.
• Keep hydrated during the day to assist the kidneys in ridding the body of toxins, but don't overdo the fluids close to bedtime.
• Get routine health tests that involve blood and urine testing to check for kidney function if you have a family history of kidney problems.
Nocturia might be inconvenient, but it might be the first indication of something being wrong with your body. Kidney disease in its early stages is usually unnoticeable, and the constant urination at night may be one of the only warning signs. If you ignore it, the condition can go on unchecked.

(Dr Vikram Barua, HOD & Consultant – Urologist, Manipal Hospital, Gurugram)