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Nocturnal polyuria is related to absent circadian rhythm of glomerular filtration rate.
J Urol. 2007 Dec; 178(6):2626-9.JU

Abstract

PURPOSE

Monosymptomatic nocturnal enuresis is frequently associated with nocturnal polyuria and low urinary osmolality during the night. Initial studies found decreased vasopressin levels associated with low urinary osmolality overnight. Together with the documented desmopressin response, this was suggestive of a primary role for vasopressin in the pathogenesis of enuresis in the absence of bladder dysfunction. Recent studies no longer confirm this primary role of vasopressin. Other pathogenetic factors such as disordered renal sodium handling, hypercalciuria, increased prostaglandins and/or osmotic excretion might have a role. So far, little attention has been given to abnormalities in the circadian rhythm of glomerular filtration rate. We evaluated the circadian rhythm of glomerular filtration rate and diuresis in children with desmopressin resistant monosymptomatic nocturnal enuresis and nocturnal polyuria.

MATERIALS AND METHODS

We evaluated 15 children (9 boys) 9 to 14 years old with monosymptomatic nocturnal enuresis and nocturnal polyuria resistant to desmopressin treatment. The control group consisted of 25 children (12 boys) 9 to 16 years old with monosymptomatic nocturnal enuresis without nocturnal polyuria.

RESULTS

Compared to the control population, children with nocturnal polyuria lost their circadian rhythm not only for diuresis and sodium excretion but also for glomerular filtration rate.

CONCLUSIONS

Patients with monosymptomatic nocturnal enuresis and nocturnal polyuria lack a normal circadian rhythm for diuresis and sodium excretion, and the circadian rhythm of glomerular filtration rate is absent. This absence of circadian rhythm of glomerular filtration rate and/or sodium handling cannot be explained by a primary role of vasopressin, but rather by a disorder in circadian rhythm of renal glomerular and/or tubular functions.

Authors+Show Affiliations

Paediatric Uro-nephrological Center, University Hospital Gent, Gent, Belgium.No 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

17945293

Citation

De Guchtenaere, A, et al. "Nocturnal Polyuria Is Related to Absent Circadian Rhythm of Glomerular Filtration Rate." The Journal of Urology, vol. 178, no. 6, 2007, pp. 2626-9.
De Guchtenaere A, Vande Walle C, Van Sintjan P, et al. Nocturnal polyuria is related to absent circadian rhythm of glomerular filtration rate. J Urol. 2007;178(6):2626-9.
De Guchtenaere, A., Vande Walle, C., Van Sintjan, P., Raes, A., Donckerwolcke, R., Van Laecke, E., Hoebeke, P., & Vande Walle, J. (2007). Nocturnal polyuria is related to absent circadian rhythm of glomerular filtration rate. The Journal of Urology, 178(6), 2626-9.
De Guchtenaere A, et al. Nocturnal Polyuria Is Related to Absent Circadian Rhythm of Glomerular Filtration Rate. J Urol. 2007;178(6):2626-9. PubMed PMID: 17945293.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nocturnal polyuria is related to absent circadian rhythm of glomerular filtration rate. AU - De Guchtenaere,A, AU - Vande Walle,C, AU - Van Sintjan,P, AU - Raes,A, AU - Donckerwolcke,R, AU - Van Laecke,E, AU - Hoebeke,P, AU - Vande Walle,J, 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 - 2626 EP - 9 JF - The Journal of urology JO - J. Urol. VL - 178 IS - 6 N2 - PURPOSE: Monosymptomatic nocturnal enuresis is frequently associated with nocturnal polyuria and low urinary osmolality during the night. Initial studies found decreased vasopressin levels associated with low urinary osmolality overnight. Together with the documented desmopressin response, this was suggestive of a primary role for vasopressin in the pathogenesis of enuresis in the absence of bladder dysfunction. Recent studies no longer confirm this primary role of vasopressin. Other pathogenetic factors such as disordered renal sodium handling, hypercalciuria, increased prostaglandins and/or osmotic excretion might have a role. So far, little attention has been given to abnormalities in the circadian rhythm of glomerular filtration rate. We evaluated the circadian rhythm of glomerular filtration rate and diuresis in children with desmopressin resistant monosymptomatic nocturnal enuresis and nocturnal polyuria. MATERIALS AND METHODS: We evaluated 15 children (9 boys) 9 to 14 years old with monosymptomatic nocturnal enuresis and nocturnal polyuria resistant to desmopressin treatment. The control group consisted of 25 children (12 boys) 9 to 16 years old with monosymptomatic nocturnal enuresis without nocturnal polyuria. RESULTS: Compared to the control population, children with nocturnal polyuria lost their circadian rhythm not only for diuresis and sodium excretion but also for glomerular filtration rate. CONCLUSIONS: Patients with monosymptomatic nocturnal enuresis and nocturnal polyuria lack a normal circadian rhythm for diuresis and sodium excretion, and the circadian rhythm of glomerular filtration rate is absent. This absence of circadian rhythm of glomerular filtration rate and/or sodium handling cannot be explained by a primary role of vasopressin, but rather by a disorder in circadian rhythm of renal glomerular and/or tubular functions. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/17945293/Nocturnal_polyuria_is_related_to_absent_circadian_rhythm_of_glomerular_filtration_rate_ L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2007.08.028?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -