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Effect of indomethacin on desmopressin resistant nocturnal polyuria and nocturnal enuresis.
J Urol. 2012 Nov; 188(5):1915-22.JU

Abstract

PURPOSE

We evaluated the acute effect of indomethacin on renal water and solute handling in children with coexisting monosymptomatic nocturnal enuresis and desmopressin resistant nocturnal polyuria, and in healthy controls.

MATERIALS AND METHODS

A total of 23 subjects were recruited, consisting of 12 children with monosymptomatic nocturnal enuresis and nocturnal polyuria with partial or no response to desmopressin, and 11 age matched controls. Children completed a 48-hour inpatient study protocol consisting of fractional urine collections and blood samples. Sodium and water intake were standardized. During the second night a dose of 50 mg indomethacin was administered orally before bedtime. Diuresis, urine osmolalities, clearances and fractional excretions were calculated for sodium, potassium, urea, osmoles and solute-free water. Renin, angiotensin II, aldosterone and atrial natriuretic peptide were measured in plasma. Prostaglandin E(2) was measured in urine.

RESULTS

Indomethacin markedly decreased the nocturnal sodium, urea and osmotic excretion in children with enuresis and controls. The overall effect on nocturnal urine output was inconsistent in the group with enuresis. Subjects in whom nocturnal diuresis was decreased following administration of indomethacin remained dry.

CONCLUSIONS

Prostaglandin inhibition leads to antidiuresis, reducing the amount of sodium, urea and osmotic excretion in children with monosymptomatic nocturnal enuresis and desmopressin resistant nocturnal polyuria. The sodium regulating hormones do not seem to mediate these processes. The overall effect in desmopressin nonresponders with nocturnal polyuria is variable. The extent to which indomethacin can be applied in the treatment of enuresis needs further evaluation.

Authors+Show Affiliations

Department of Pediatrics, Aarhus University Hospital, Skejby, Denmark. kostas.kamperis@ki.au.dkNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22999686

Citation

Kamperis, Konstantinos, et al. "Effect of Indomethacin On Desmopressin Resistant Nocturnal Polyuria and Nocturnal Enuresis." The Journal of Urology, vol. 188, no. 5, 2012, pp. 1915-22.
Kamperis K, Rittig S, Bower WF, et al. Effect of indomethacin on desmopressin resistant nocturnal polyuria and nocturnal enuresis. J Urol. 2012;188(5):1915-22.
Kamperis, K., Rittig, S., Bower, W. F., & Djurhuus, J. C. (2012). Effect of indomethacin on desmopressin resistant nocturnal polyuria and nocturnal enuresis. The Journal of Urology, 188(5), 1915-22. https://doi.org/10.1016/j.juro.2012.07.019
Kamperis K, et al. Effect of Indomethacin On Desmopressin Resistant Nocturnal Polyuria and Nocturnal Enuresis. J Urol. 2012;188(5):1915-22. PubMed PMID: 22999686.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of indomethacin on desmopressin resistant nocturnal polyuria and nocturnal enuresis. AU - Kamperis,Konstantinos, AU - Rittig,Søren, AU - Bower,Wendy F, AU - Djurhuus,Jens C, Y1 - 2012/09/19/ PY - 2012/03/05/received PY - 2012/9/25/entrez PY - 2012/9/25/pubmed PY - 2013/1/1/medline SP - 1915 EP - 22 JF - The Journal of urology JO - J Urol VL - 188 IS - 5 N2 - PURPOSE: We evaluated the acute effect of indomethacin on renal water and solute handling in children with coexisting monosymptomatic nocturnal enuresis and desmopressin resistant nocturnal polyuria, and in healthy controls. MATERIALS AND METHODS: A total of 23 subjects were recruited, consisting of 12 children with monosymptomatic nocturnal enuresis and nocturnal polyuria with partial or no response to desmopressin, and 11 age matched controls. Children completed a 48-hour inpatient study protocol consisting of fractional urine collections and blood samples. Sodium and water intake were standardized. During the second night a dose of 50 mg indomethacin was administered orally before bedtime. Diuresis, urine osmolalities, clearances and fractional excretions were calculated for sodium, potassium, urea, osmoles and solute-free water. Renin, angiotensin II, aldosterone and atrial natriuretic peptide were measured in plasma. Prostaglandin E(2) was measured in urine. RESULTS: Indomethacin markedly decreased the nocturnal sodium, urea and osmotic excretion in children with enuresis and controls. The overall effect on nocturnal urine output was inconsistent in the group with enuresis. Subjects in whom nocturnal diuresis was decreased following administration of indomethacin remained dry. CONCLUSIONS: Prostaglandin inhibition leads to antidiuresis, reducing the amount of sodium, urea and osmotic excretion in children with monosymptomatic nocturnal enuresis and desmopressin resistant nocturnal polyuria. The sodium regulating hormones do not seem to mediate these processes. The overall effect in desmopressin nonresponders with nocturnal polyuria is variable. The extent to which indomethacin can be applied in the treatment of enuresis needs further evaluation. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/22999686/Effect_of_indomethacin_on_desmopressin_resistant_nocturnal_polyuria_and_nocturnal_enuresis_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2012.07.019?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -