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Overlap between nocturnal polyuria, diurnal polyuria, and 24-h polyuria among men with nocturia.
Int Urol Nephrol. 2020 May 20 [Online ahead of print]IU

Abstract

PURPOSE

A recent update in International Continence Society (ICS) terminology now recognizes nocturnal polyuria (NP) and diurnal polyuria (DP) as related subcategories of "Polyuria (global symptom)". This study determines the real-world clinical overlap between NP, DP, and 24-h polyuria (24hP) among men with nocturia.

METHODS

Analysis of frequency-volume charts from men ≥ 18 years with ≥ 1 nocturnal void(s). Three separate analyses were performed using different rate criteria for NP, DP, and 24hP: (1) urine production > 90 mL/h (extrapolated from a proposed definition for NP); (2) > 125 mL/h (extrapolated from a proposed definition for 24hP [3000 mL/24 h]); and (3) > 1.67 mL/kg/h (extrapolated from the current ICS definition for 24hP [> 40 mL/kg/24 h]). Subjects were categorized as having one of five mathematically permissible phenotypic combinations: (1) isolated NP, (2) isolated DP, (3) NP + 24hP, (4) DP + 24hP, and (5) NP + DP + 24hP.

RESULTS

167, 95, and 61 patients were included at criteria 1, 2, and 3, respectively, with 56%, 43%, and 30% of patients demonstrating overlapping phenotypes (i.e., phenotypic combinations 3-5) at cut-offs 1-3, respectively. The prevalence of NP was similar across cut-offs (81-87%), but the prevalence of NP without 24hP was highly threshold-dependent (43-73%).

CONCLUSION

Consistent with current ICS terminology, there exists a substantial overlap between NP, DP, and 24hP. As demonstrated in the current study, absolute volume-based criteria for NP/DP/24hP are indeed conducive to the diagnosis of concurrent NP + 24hP, and may be preferred over proportion-based NP criteria when both NP + 24hP are suspected.

Authors+Show Affiliations

Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA. monaghantf@gmail.com.Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.Division of Cardiovascular Medicine, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.Division of Endocrinology and Metabolism, Department of Medicine, Georgetown University Medical Center, Washington, DC, USA.Department of Urology, Ghent University Hospital, Ghent, Belgium.Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA. Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.Division of Urology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32435976

Citation

Monaghan, Thomas F., et al. "Overlap Between Nocturnal Polyuria, Diurnal Polyuria, and 24-h Polyuria Among Men With Nocturia." International Urology and Nephrology, 2020.
Monaghan TF, Rahman SN, Miller CD, et al. Overlap between nocturnal polyuria, diurnal polyuria, and 24-h polyuria among men with nocturia. Int Urol Nephrol. 2020.
Monaghan, T. F., Rahman, S. N., Miller, C. D., Agudelo, C. W., Michelson, K. P., Nwannunu, N. A., Lazar, J. M., Bliwise, D. L., Verbalis, J. G., Everaert, K., Blaivas, J. G., Wein, A. J., & Weiss, J. P. (2020). Overlap between nocturnal polyuria, diurnal polyuria, and 24-h polyuria among men with nocturia. International Urology and Nephrology. https://doi.org/10.1007/s11255-020-02502-1
Monaghan TF, et al. Overlap Between Nocturnal Polyuria, Diurnal Polyuria, and 24-h Polyuria Among Men With Nocturia. Int Urol Nephrol. 2020 May 20; PubMed PMID: 32435976.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Overlap between nocturnal polyuria, diurnal polyuria, and 24-h polyuria among men with nocturia. AU - Monaghan,Thomas F, AU - Rahman,Syed N, AU - Miller,Connelly D, AU - Agudelo,Christina W, AU - Michelson,Kyle P, AU - Nwannunu,Nelson A, AU - Lazar,Jason M, AU - Bliwise,Donald L, AU - Verbalis,Joseph G, AU - Everaert,Karel, AU - Blaivas,Jerry G, AU - Wein,Alan J, AU - Weiss,Jeffrey P, Y1 - 2020/05/20/ PY - 2020/03/19/received PY - 2020/05/09/accepted PY - 2020/5/22/entrez KW - Diuresis KW - Hypervolemia KW - Natriuresis KW - Systemic KW - Vasopressin JF - International urology and nephrology JO - Int Urol Nephrol N2 - PURPOSE: A recent update in International Continence Society (ICS) terminology now recognizes nocturnal polyuria (NP) and diurnal polyuria (DP) as related subcategories of "Polyuria (global symptom)". This study determines the real-world clinical overlap between NP, DP, and 24-h polyuria (24hP) among men with nocturia. METHODS: Analysis of frequency-volume charts from men ≥ 18 years with ≥ 1 nocturnal void(s). Three separate analyses were performed using different rate criteria for NP, DP, and 24hP: (1) urine production > 90 mL/h (extrapolated from a proposed definition for NP); (2) > 125 mL/h (extrapolated from a proposed definition for 24hP [3000 mL/24 h]); and (3) > 1.67 mL/kg/h (extrapolated from the current ICS definition for 24hP [> 40 mL/kg/24 h]). Subjects were categorized as having one of five mathematically permissible phenotypic combinations: (1) isolated NP, (2) isolated DP, (3) NP + 24hP, (4) DP + 24hP, and (5) NP + DP + 24hP. RESULTS: 167, 95, and 61 patients were included at criteria 1, 2, and 3, respectively, with 56%, 43%, and 30% of patients demonstrating overlapping phenotypes (i.e., phenotypic combinations 3-5) at cut-offs 1-3, respectively. The prevalence of NP was similar across cut-offs (81-87%), but the prevalence of NP without 24hP was highly threshold-dependent (43-73%). CONCLUSION: Consistent with current ICS terminology, there exists a substantial overlap between NP, DP, and 24hP. As demonstrated in the current study, absolute volume-based criteria for NP/DP/24hP are indeed conducive to the diagnosis of concurrent NP + 24hP, and may be preferred over proportion-based NP criteria when both NP + 24hP are suspected. SN - 1573-2584 UR - https://www.unboundmedicine.com/medline/citation/32435976/Overlap_between_nocturnal_polyuria,_diurnal_polyuria,_and_24-h_polyuria_among_men_with_nocturia L2 - https://doi.org/10.1007/s11255-020-02502-1 DB - PRIME DP - Unbound Medicine ER -
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