Question: Hello Dr,
I am experiencing variable urine output, and have been becoming increasingly concerned and obsessive about my symptoms and have been in the ER numerous times, thinking my kidneys must not be working properly. Every test comes out normal; just two days ago I had CMP, urinalysis with microscope tests, and ultrasound of heart, kidneys, and bladder and everything was normal/negative. Creatinine was .7, BUN 10.

I have seen a urologist and a nephrologist and have been told that with my perfect lab results, there is no need for any further testing. I have done a 24 hour urine volume test and it was 2.6 liters, but I know it's frequently much less. For example, some mornings I will drink 16 oz of water and need to urinate urgently twice and some days, with no difference in sweating/activity, I'll barely have to urinate even once. I understand about "insensible losses" but does that explain the wide variation?

I should explain that I became quite concerned, and now obsessive about fluid intake/output when I had PVC-induced cardiomyopathy which was resolved with an ablation. I had a doctor who was extremely vigilant about fluid and told me I was always going to be in danger of CHF and that if urinated less than every two hours, I needed to go to the ER. He said my body couldn't process water, and even though I've recovered, I'm now terrified about a recurrence or something new happening as I was asymptomatic even with cardiomyopathy. Is this completely irrational? Is it impossible for me to be having pathological water retention when my labs and tests are all perfectly normal? I monitor every drop I drink and am scared all day long when I drink. Thank you so much. Lab work is attached.

Thank you so much, doctor. I don't know how to stop being so afraid of difference in urine output. I measure some days and the other day I had 3.8 liter output but some days maybe half that even though it seems that input and activity and food were very similar. I just can't believe that that could be normal. But is all ok because all my labs are good? Do I need more than annual check of kidney function? I am always worried that in short period of time, something has changed and my heart/kidneys could be failing. Is this completely irrational and just my anxiety?

Thank you so much, dr.

Thank you so much, doctor. I do know I have OCD and PTSD from my prior diagnosis and I am getting therapy from an OCD specialist and also seeing a psychiatrist for medications.

I know that anxiety is causing most of my distress but I also fear thar somehow something is being missed. Would I definitely have other symptoms as well as signs in bloodwork and UA which have been consistently normal?

I suppose no doctor would think I needed any further testing? I so badly want to feel normal again but get so scared to live my life normally.

Thank you so much, doctor, for your knowledge and patience.