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Nocturnal polyuria is related to 24-hour diuresis and osmotic excretion in an enuresis population referred to a tertiary center.
J Urol. 2007 Dec; 178(6):2630-4.JU

Abstract

PURPOSE

Primary nocturnal enuresis is a heterogeneous disorder, causing a mismatch between overnight diuresis volume and functional bladder capacity. Despite increasing insights in pathogenesis, lack of efficacy of the available treatments is a major problem. We evaluated characteristics of bladder volume and diuresis rate in patients with nocturnal enuresis referred to a tertiary enuresis center.

MATERIALS AND METHODS

Noninvasive screening including maximal voided volume, 24-hour circadian rhythm of diuresis and osmotic excretion from 1,000 consecutive patients.

RESULTS

Of the patients referred as having monosymptomatic nocturnal enuresis 32% were subsequently classified as having nonmonosymptomatic nocturnal enuresis. Differences in bladder volume and nocturnal diuresis characteristics between the monosymptomatic nocturnal enuresis and nonmonosymptomatic nocturnal enuresis groups were minimal.

CONCLUSIONS

The most common observation is a nocturnal diuresis volume greater than maximal voided volume, which in both groups can be caused by nocturnal polyuria or small bladder volume for patient age. The most striking observation is that the positive correlation between nocturnal diuresis volume rate and nocturnal osmotic excretion and 24-hour fluid intake is significantly higher than with the inversed urinary osmolality overnight, which is not only unexpected based on the theory of the primary suppression of vasopressin levels overnight, but also points to a more important role for nutritional and fluid intake than accepted, if not in the primary pathogenesis, then at least in therapy resistance.

Authors+Show Affiliations

Department of Pediatric Nephrology, University Hospital Gent, Gent, Belgium. Johan.VandeWalle@ugent.beNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17945292

Citation

Vande Walle, J, et al. "Nocturnal Polyuria Is Related to 24-hour Diuresis and Osmotic Excretion in an Enuresis Population Referred to a Tertiary Center." The Journal of Urology, vol. 178, no. 6, 2007, pp. 2630-4.
Vande Walle J, Vande Walle C, Van Sintjan P, et al. Nocturnal polyuria is related to 24-hour diuresis and osmotic excretion in an enuresis population referred to a tertiary center. J Urol. 2007;178(6):2630-4.
Vande Walle, J., Vande Walle, C., Van Sintjan, P., De Guchtenaere, A., Raes, A., Donckerwolcke, R., Van Laecke, E., Mauel, R., Dehoorne, J., Van Hoyweghen, E., & Hoebeke, P. (2007). Nocturnal polyuria is related to 24-hour diuresis and osmotic excretion in an enuresis population referred to a tertiary center. The Journal of Urology, 178(6), 2630-4.
Vande Walle J, et al. Nocturnal Polyuria Is Related to 24-hour Diuresis and Osmotic Excretion in an Enuresis Population Referred to a Tertiary Center. J Urol. 2007;178(6):2630-4. PubMed PMID: 17945292.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nocturnal polyuria is related to 24-hour diuresis and osmotic excretion in an enuresis population referred to a tertiary center. AU - Vande Walle,J, AU - Vande Walle,C, AU - Van Sintjan,P, AU - De Guchtenaere,A, AU - Raes,A, AU - Donckerwolcke,R, AU - Van Laecke,E, AU - Mauel,R, AU - Dehoorne,J, AU - Van Hoyweghen,E, AU - Hoebeke,P, Y1 - 2007/10/22/ PY - 2007/03/12/received PY - 2007/10/20/pubmed PY - 2008/1/5/medline PY - 2007/10/20/entrez SP - 2630 EP - 4 JF - The Journal of urology JO - J. Urol. VL - 178 IS - 6 N2 - PURPOSE: Primary nocturnal enuresis is a heterogeneous disorder, causing a mismatch between overnight diuresis volume and functional bladder capacity. Despite increasing insights in pathogenesis, lack of efficacy of the available treatments is a major problem. We evaluated characteristics of bladder volume and diuresis rate in patients with nocturnal enuresis referred to a tertiary enuresis center. MATERIALS AND METHODS: Noninvasive screening including maximal voided volume, 24-hour circadian rhythm of diuresis and osmotic excretion from 1,000 consecutive patients. RESULTS: Of the patients referred as having monosymptomatic nocturnal enuresis 32% were subsequently classified as having nonmonosymptomatic nocturnal enuresis. Differences in bladder volume and nocturnal diuresis characteristics between the monosymptomatic nocturnal enuresis and nonmonosymptomatic nocturnal enuresis groups were minimal. CONCLUSIONS: The most common observation is a nocturnal diuresis volume greater than maximal voided volume, which in both groups can be caused by nocturnal polyuria or small bladder volume for patient age. The most striking observation is that the positive correlation between nocturnal diuresis volume rate and nocturnal osmotic excretion and 24-hour fluid intake is significantly higher than with the inversed urinary osmolality overnight, which is not only unexpected based on the theory of the primary suppression of vasopressin levels overnight, but also points to a more important role for nutritional and fluid intake than accepted, if not in the primary pathogenesis, then at least in therapy resistance. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/17945292/Nocturnal_polyuria_is_related_to_24_hour_diuresis_and_osmotic_excretion_in_an_enuresis_population_referred_to_a_tertiary_center_ L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2007.08.029?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -