No abstract

OBJECTIVE To investigate the association between nocturia and selected concomitant diseases and medications in a community‐dwelling elderly population. SUBJECTS AND METHODS Data were obtained with a validated questionnaire mailed to all inhabitants aged ≥ 65 years in Tierp, Sweden. Descriptive statistics on age, gender, concomitant diseases and medications were calculated for non‐nocturics (subjects reporting a mean of < 1 void/night), intermediate (reporting a mean of 1–2 voids/night) and nocturics (reporting a mean of ≥ 2 voids/night). Correlations between the number of nocturnal voids/week and concomitant diseases/medications were investigated with logistic regression, controlling for age and gender. RESULTS Of the 4264 questionnaires sent, 67% (2866) were returned, of which 73% (2081) were fully evaluable on nocturia and incorporated in the analysis. Of these, 62% reported ≥ 1 void/night and 29%≥ 2 voids/night. The median (range) age of the respondents was 74 (65–99) years. The prevalence of nocturia increased with age and men reported more nocturia than women. The nocturic group had the highest percentage of reported disease and medication on each question. In the logistic regression, controlling for age and gender, there was no significant correlation between the number of nocturnal voids and hypertension, angina pectoris or diabetes mellitus, nor with treatment of these diseases. Neither was there any correlation for congestive heart failure, snoring, use of diuretics or hypnotics. There were highly statistically significant correlations (P < 0.001) between the increase in number of nocturnal voids and incontinence, daytime urge and nocturnal thirst. The increase in number of nocturnal voids was negatively correlated with good sleep and with feeling in good health (P < 0.001). CONCLUSION There was no correlation between the number of nocturnal voids and a known and treated hypertension, angina pectoris, congestive heart failure or diabetes mellitus. The number of nocturnal voids was highly correlated with urge and incontinence.

This is an author produced version of a paper published in Neurourology and Urodynamics. This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal pagination.Citation for the published paper: Rembratt, A and Riis, A and Norgaard, J P "Desmopressin treatment in nocturia; an analysis of risk factors for hyponatremia."Neurourol Urodyn. with age, lower serum sodium concentration at baseline, higher basal 24-h urine volume per bodyweight and weight gain at time of minimum serum sodium concentration. Age was the best single predictor. Elderly patients (≥65 years of age) with a baseline serum sodium concentration below normal range were at high risk (75%). Limiting treatment in elderly with normal basal serum sodium concentration to those below 79 years and with a 24-hour urine output below 28 mL/kg would reduce the risk from 8.1 to 3.0% at the cost of 34% fulfilling the contra-indication. Conclusions:The majority of nocturia patients tolerate desmopressin treatment without clinically significant hyponatremia. However, the risk increases with increasing age and decreasing baseline serum sodium concentration. Treatment of nocturia in elderly 3( patients with desmopressin should only be undertaken together with careful monitoring of the serum sodium concentration. Patients with a baseline serum sodium concentration below normal range should not be treated.