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Time of peak nocturnal diuresis rate between men with secondary nocturnal polyuria versus nocturnal polyuria syndrome.
Neurourol Urodyn. 2020 02; 39(2):785-792.NU

Abstract

AIM

Compare the circadian trajectory of diuresis between nocturnal polyuria (NP) patients with versus without identifiable contributory comorbidities.

METHODS

Retrospective analysis of frequency-volume charts from male patients with clinically-significant nocturia (≥2 nocturnal voids) and NP (defined by nocturnal urine production [NUP] ≥90 mL/hour or nocturnal polyuria index [NPi] ≥0.33). Patients with NP and chronic kidney disease, congestive heart failure, and/or undertreated obstructive sleep apnea (OSA) were deemed to have secondary NP. Nocturnal polyuria syndrome (NPS) was defined as NP without edema, loop diuretic use, or the aforementioned conditions. Patients with diabetes insipidus or OSA with appropriate continuous positive airway pressure utilization were excluded. The timing and volumes of nocturnal voids were used to derive "early" and "late" nocturnal diuresis rates (mL/hour of urine produced before and after the first nocturnal awakening, respectively). The likelihood of an early peak nocturnal diuresis rate (ie, early >late nocturnal diuresis rate) was compared between patients with NPS versus secondary NP using both a crude and adjusted odds ratio.

RESULTS

The likelihood of an early peak nocturnal diuresis rate in patients with NPS compared with secondary NP was 2.58 (1.05-6.31) at NUP ≥ 90 mL/hour and 1.96 (0.87-4.42) at NPi ≥ 0.33 on crude analysis, and 2.44 (0.96-6.24) and 1.93 (0.83-4.48) after adjustment, respectively.

CONCLUSIONS

A peak early nocturnal diuresis rate was significantly more likely in patients with NPS at NUP ≥ 90 mL/hour, with similar odds ratios at NPi ≥ 0.33 and following adjustment. Delineating nocturic patients by NP subgroup may facilitate more individualized management.

PATIENT SUMMARY

Many people have to wake up to urinate because they produce too much urine at night-a condition known as "nocturnal polyuria." Nocturnal polyuria might be caused by drinking too much fluid, other behavioral factors, or conditions that make your body hold on to too much fluid, like heart disease, kidney disease, and sleep apnea. In cases of nocturnal polyuria where no clear cause can be identified, it is thought that patients may suffer from a deficiency in nighttime vasopressin, a hormone that plays a key role in how much urine you produce. In this study, we compared the pattern of nighttime urine production in patients with different causes of nocturnal polyuria, which may lead to more personalized treatment options for patients with this condition.

Authors+Show Affiliations

Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York. Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York.Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York. Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York.Department of Neurology, Emory University School of Medicine, Atlanta, Georgia.Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York. Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York.Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York. Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York.Division of Cardiovascular Medicine, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York.Department of Urology, Ghent University Hospital, Ghent, Belgium.Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York.Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York. Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York.Division of Urology, Perelman School of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania.Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York. Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31961968

Citation

Monaghan, Thomas F., et al. "Time of Peak Nocturnal Diuresis Rate Between Men With Secondary Nocturnal Polyuria Versus Nocturnal Polyuria Syndrome." Neurourology and Urodynamics, vol. 39, no. 2, 2020, pp. 785-792.
Monaghan TF, Epstein MR, Bliwise DL, et al. Time of peak nocturnal diuresis rate between men with secondary nocturnal polyuria versus nocturnal polyuria syndrome. Neurourol Urodyn. 2020;39(2):785-792.
Monaghan, T. F., Epstein, M. R., Bliwise, D. L., Michelson, K. P., Wu, Z. D., Lazar, J. M., Everaert, K., Kabarriti, A. E., Holmes, A., Wein, A. J., & Weiss, J. P. (2020). Time of peak nocturnal diuresis rate between men with secondary nocturnal polyuria versus nocturnal polyuria syndrome. Neurourology and Urodynamics, 39(2), 785-792. https://doi.org/10.1002/nau.24283
Monaghan TF, et al. Time of Peak Nocturnal Diuresis Rate Between Men With Secondary Nocturnal Polyuria Versus Nocturnal Polyuria Syndrome. Neurourol Urodyn. 2020;39(2):785-792. PubMed PMID: 31961968.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Time of peak nocturnal diuresis rate between men with secondary nocturnal polyuria versus nocturnal polyuria syndrome. AU - Monaghan,Thomas F, AU - Epstein,Matthew R, AU - Bliwise,Donald L, AU - Michelson,Kyle P, AU - Wu,Zhan D, AU - Lazar,Jason M, AU - Everaert,Karel, AU - Kabarriti,Abdo E, AU - Holmes,Arturo, AU - Wein,Alan J, AU - Weiss,Jeffrey P, Y1 - 2020/01/21/ PY - 2019/09/04/received PY - 2020/01/09/accepted PY - 2020/1/22/pubmed PY - 2020/1/22/medline PY - 2020/1/22/entrez KW - antidiuretic KW - circadian KW - diuretic KW - nocturia KW - phenotype KW - renal KW - vasopressin SP - 785 EP - 792 JF - Neurourology and urodynamics JO - Neurourol. Urodyn. VL - 39 IS - 2 N2 - AIM: Compare the circadian trajectory of diuresis between nocturnal polyuria (NP) patients with versus without identifiable contributory comorbidities. METHODS: Retrospective analysis of frequency-volume charts from male patients with clinically-significant nocturia (≥2 nocturnal voids) and NP (defined by nocturnal urine production [NUP] ≥90 mL/hour or nocturnal polyuria index [NPi] ≥0.33). Patients with NP and chronic kidney disease, congestive heart failure, and/or undertreated obstructive sleep apnea (OSA) were deemed to have secondary NP. Nocturnal polyuria syndrome (NPS) was defined as NP without edema, loop diuretic use, or the aforementioned conditions. Patients with diabetes insipidus or OSA with appropriate continuous positive airway pressure utilization were excluded. The timing and volumes of nocturnal voids were used to derive "early" and "late" nocturnal diuresis rates (mL/hour of urine produced before and after the first nocturnal awakening, respectively). The likelihood of an early peak nocturnal diuresis rate (ie, early >late nocturnal diuresis rate) was compared between patients with NPS versus secondary NP using both a crude and adjusted odds ratio. RESULTS: The likelihood of an early peak nocturnal diuresis rate in patients with NPS compared with secondary NP was 2.58 (1.05-6.31) at NUP ≥ 90 mL/hour and 1.96 (0.87-4.42) at NPi ≥ 0.33 on crude analysis, and 2.44 (0.96-6.24) and 1.93 (0.83-4.48) after adjustment, respectively. CONCLUSIONS: A peak early nocturnal diuresis rate was significantly more likely in patients with NPS at NUP ≥ 90 mL/hour, with similar odds ratios at NPi ≥ 0.33 and following adjustment. Delineating nocturic patients by NP subgroup may facilitate more individualized management. PATIENT SUMMARY: Many people have to wake up to urinate because they produce too much urine at night-a condition known as "nocturnal polyuria." Nocturnal polyuria might be caused by drinking too much fluid, other behavioral factors, or conditions that make your body hold on to too much fluid, like heart disease, kidney disease, and sleep apnea. In cases of nocturnal polyuria where no clear cause can be identified, it is thought that patients may suffer from a deficiency in nighttime vasopressin, a hormone that plays a key role in how much urine you produce. In this study, we compared the pattern of nighttime urine production in patients with different causes of nocturnal polyuria, which may lead to more personalized treatment options for patients with this condition. SN - 1520-6777 UR - https://www.unboundmedicine.com/medline/citation/31961968/Time_of_peak_nocturnal_diuresis_rate_between_men_with_secondary_nocturnal_polyuria_versus_nocturnal_polyuria_syndrome_ L2 - https://doi.org/10.1002/nau.24283 DB - PRIME DP - Unbound Medicine ER -
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