Condition | Associated clinical features from history, examination, or urinalysis |
Underlying renal/urologic abnormalities |
Bladder dysfunction | - Daytime wetting
- Lower urinary tract symptoms (eg, urgency, holding maneuvers, interrupted micturition)
- Wetness in the undergarments
|
Urinary tract infection | - Abnormal urinalysis (pyuria, bacteriuria)
|
Chronic kidney disease | - Poor growth or weight loss
- Hypertension
- Abnormal urinalysis (proteinuria, hematuria)
- Edema
- With progressive deterioration of kidney function:
- Anorexia
- Vomiting
- Weakness
- Fatigue
|
Posterior urethral valves | - Incomplete bladder emptying (by percussion and/or palpation of bladder)
- Straining to void
- Large volumes of voided urine
- Slow or intermittent urinary stream
- Dribbling of urine
- Urinary tract infections
- Poor weight gain
|
Ectopic ureter (only in females) | - Persistent dampness in underwear
- Absence of dry episodes
|
Other underlying medical conditions |
Fecal incontinence or constipation | - History of soiling
- History of infrequent stooling
- Palpation of stool in the abdomen
|
Sickle cell disease | - Family history of sickle cell disease
- Abnormal urinalysis (decreased specific gravity, hematuria, proteinuria)
|
Seizures | - Paroxysmal, stereotyped behaviors (eg, staring, limb movements, loss of tone)
|
Diabetes mellitus | - Polyuria
- Polydipsia
- Weight loss
- Glucosuria
|
Diabetes insipidus | - Polyuria
- Polydipsia
- Decreased specific gravity on first morning void
|
Spinal dysraphism | - Abnormalities in the lumbosacral spine (eg, hair tuft, dermal sinus tract, dimple, or pit)
- Lower extremity weakness, sensory loss, abnormal tone
- Abnormal gait
- Abnormal plantar response
|
Obstructive sleep apnea | - Snoring
- Signs of adenotonsillar hypertrophy (eg, mouth breathing, adenoid facies)
|
Pinworms | - Perianal excoriation
- Vulvovaginitis
|
Primary polydipsia | - History of increased water intake
- Polyuria
|