When you lie down in bed at night, the fluid that has built up in your legs during the day can move back into your bloodstream and is taken to your kidneys to be eliminated as waste urine. Going to the toilet before going to bed and limiting the amount you drink in the evening may help reduce the number of times you have to get up at night to urinate.
It is recommended to take hydrochlorothiazide in the daytime to avoid the urge to urinate frequently at night.
Since hydrochlorothiazide causes frequent urination, it is advised that the medication be taken in the morning or afternoon to avoid sleep disturbances during the night. Chronic renal failure patients will have increased urine output and the frequency of urination will also increase especially frequent urination at nights. Usually when GFR reduces to 10%-25% and creatinine is elevated to 450-707, there will be obvious increased night urination and at the same time there will be anemia, water and electrolyte disorder, blood in urine and bubbles in urine. Under normal circumstances, urine output at night is less than that during the daytime because of low metabolism and slow blood flow at nights. However if there is frequent urination at night (more than 2 times) and much increased night urine output and this condition lasts for a long time, it usually indicates kidney problems.
In case of many kidney diseases---glomerular diseases, chronic tubular interstitial diseases, the first symptom and sign will be frequent night urination due to declined renal function of concentration.

Another reason is that the damaged kidney can not discharge all the metabolic wastes and toxins during the daytime and the kidneys have to work at nights to discharged the remaining wasteful products. Mental factors such as high nervousness can cause frequent night urination, but usually the volume does not increase. Cardiac insufficiency or endocrine disease such as chronic adrenal insufficiency can also cause frequent urinating at night. However if the frequent night urination is confirmed to be caused by renal disease, you are recommended to go to local kidney disease hospital and seek professional and early treatment. Older men with enlarged prostrate experience pressure on the urethra which prevents the bladder from emptying appropriately causing the urge to urinate frequently. People experiencing nocturia have frequent sleep disruptions as they should get up and visit the toilet to urinate the excessive urine.
Waking twice or more to urinate at night can be really bothering particularly for the aged people. High blood pressure and diabetes are common factors that can damage renal concentration function and cause frequent night urination and increased night urine output. One such outcome is nocturia, or night time urination, where the patient involuntarily wakes-up at night to urinate. Nocturia may not seem a problematic outcome but it is likely to pose damaging consequences when left unattended or untreated.

Nocturia is likely to interrupt the brain impulses which control and coordinate urination. This is possibly the most adverse outcome of nocturia which can produce more psychological outcomes compared to the physical ones. A Sleep in America poll revealed that as many as nearly two-thirds of us report having to get up at night to go to the bathroom.NocturiaFrequent urination at night is called nocturia. Nocturia, on the other hand, involves a person waking up one or more times a night with the need to empty his or her bladder. In addition, frequent urination at night is not the same as urinary incontinence; the latter of which occurs when a person has lost partial or complete voluntary control of their bladder function.
In order to diagnose your cause of your nocturia, your doctor may order diagnostic tests, such a urinalysis cystometry (measures the pressure in your bladder), ultrasound of your bladder and urinary tract system, urinalysis, neurological tests for urgency issues, or he may recommend testing at a sleep center.

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