Nocturnal polyuria in monosymptomatic nocturnal enuresis refractory to desmopressin treatment

• Published in: American journal of physiology. Renal physiology 2006-12, Vol.291 (6), p.F1232-F1240
• Main Authors: Kamperis, K, Rittig, S, Jørgensen, K A, Djurhuus, J C
• Format: Article
• Language: English
• Subjects: Adolescent; Aldosterone - blood; Antidiuretic Agents; Aquaporin 2 - urine; Arginine Vasopressin - blood; Arginine Vasopressin - urine; Atrial Natriuretic Factor - blood; Child; Children & youth; Circadian Rhythm; Deamino Arginine Vasopressin; Dinoprostone - urine; Drinking; Drug Resistance; Drugs; Female; Humans; Kidney diseases; Male; Natriuresis - drug effects; Nephrology; Nocturnal Enuresis - drug therapy; Nocturnal Enuresis - metabolism; Nocturnal Enuresis - physiopathology; Polyuria - drug therapy; Polyuria - metabolism; Polyuria - physiopathology; Renin - blood; Sodium - blood; Sodium - urine; Sodium Chloride, Dietary; Urea - blood; Urea - urine; Urine
• ISSN: 1931-857X; 1522-1466
• DOI: 10.1152/ajprenal.00134.2006

The transition from day to night is associated with a pronounced decline in diuresis with reductions in the amount of excreted water, electrolytes, and other end products of our metabolism. Failure to do so leads to a large urine output at night, a condition known as nocturnal polyuria, encountered in a large proportion of children with nocturnal enuresis. The aim of this study was to clarify the mechanisms responsible for the nocturnal polyuria seen in enuretics with inadequate response to desmopressin (dDAVP). Forty-six enuretics (7-14 yr of age) and fifteen age-matched controls were admitted for a 24-h protocol with standardized fluid and sodium intake, comprising urine collections, blood sampling, and blood pressure monitoring. We included patients with severe enuresis (5 +/- 1 wet nights/wk) showing