Antidiuresis therapy: Mechanism of action and clinical implications

Nørgaard, Jens Peter; Hashim, Hashim; Malmberg, Lars‐Erik; Robinson, Dudley

doi:10.1002/nau.20437

Cited by 39 publications

(21 citation statements)

References 77 publications

(76 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The result is 24‐hour polyuria and polydipsia, known as diabetes insipidus, which is a rare condition diagnosed via a bladder diary and a low morning (fasting) serum and urine osmolality. An abnormal circadian rhythm of vasopressin is the main mechanism for NP . Asplund described a lack of circadian rhythm in patients with NP and nocturia in both men and women, but plasma levels in adults without nocturia peak at around 8 pg/mL in men and 4 pg/mL in women—both with a circadian rhythm .…”

Section: Resultsmentioning

confidence: 99%

International Continence Society consensus on the diagnosis and treatment of nocturia

Everaert

Hervé

Bosch

et al. 2019

Neurourology and Urodynamics

Self Cite

109

104

View full text Add to dashboard Cite

Introduction Patients with nocturia have to face many hurdles before being diagnosed and treated properly. The aim of this paper is to: summarize the nocturia patient pathway, explore how nocturia is diagnosed and treated in the real world and use the Delphi method to develop a practical algorithm with a focus on what steps need to be taken before prescribing desmopressin. Methods Evidence comes from existing guidelines (Google, PubMed), International Consultation on Incontinence‐Research Society (ICI‐RS) 2017, prescribing information and a Delphi panel (3 rounds). The International Continence Society initiated this study, the authors represent the ICI‐RS, European Association of Urology, and Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU). Results Diagnostic packages: consensus on, history taking for all causalities, intake diary (fluid, food) and bladder diary, not for its duration. Pelvic (women) or rectal (men) examination, prostate‐specific antigen, serum sodium check (SSC), renal function, endocrine screening: when judged necessary. Timing or empty stomach when SSC is not important. Therapeutic packages: the safe candidates for desmopressin can be phenotyped as no polydipsia, heart/kidney failure, severe leg edema or obstructive sleep apnea syndrome. Lifestyle interventions may be useful. Initiating desmopressin: risk management consensus on three clinical pictures. Follow‐up of desmopressin therapy: there was consensus on SSC day 3 to 7, and at 1 month. Stop therapy if SSC is <130 mmol/L regardless of symptoms. Stop if SSC is 130 to 135 mmol/L with symptoms of hyponatremia. Conclusion A summary of the nocturia patient pathway across different medical specialists is useful in the visualization and phenotyping of patients for diagnosis and therapy. By summarizing basic knowledge of desmopressin, we aim to ease its initiation and shorten the patient journey for nocturia.

show abstract

Section: Resultsmentioning

confidence: 99%

International Continence Society consensus on the diagnosis and treatment of nocturia

Everaert

Hervé

Bosch

et al. 2019

Neurourology and Urodynamics

Self Cite

109

104

View full text Add to dashboard Cite

show abstract

“…Sleep apnea is known to lead to an increase in atrial natriuretic peptide, resulting in nocturnal natriuresis and consequently increased diuresis (solute diuresis) which does not respond to vasopressin receptor 2 (V 2 ) agonist treatment (desmopressin). 44 A number of studies have shown a decrease in nocturia episodes and/or nocturnal urine production with continuous positive airflow pressure therapy treatment for sleep apnea. 45, 46 In other patients with NP and a dilute diuresis, antidiuretic therapy may be effective.…”

Section: Treatment Of Nocturiamentioning

confidence: 99%

“…45, 46 In other patients with NP and a dilute diuresis, antidiuretic therapy may be effective. Desmopressin is a synthetic analogue of the naturally-occurring antidiuretic hormone, arginine vasopressin, and it has been found to be an effective treatment in nocturia patients, 44 with mean number of voids per night reduced to less than two on average. 47-49 Reductions in nocturia frequency with treatment are accompanied by a significant increase in the hours of undisturbed sleep 50 (Figure 2), and a lengthening of the initial sleep period compared with placebo.…”

Section: Treatment Of Nocturiamentioning

confidence: 99%

The effect of nocturia on sleep

Ancoli‐Israel

Bliwise

Nørgaard

2011

Sleep Medicine Reviews

Self Cite

113

View full text Add to dashboard Cite

Sleep plays a vital role in physical and mental functioning. It is increasingly recognized that disturbed sleep is a highly prevalent and chronic condition that merits greater awareness due to the wide-ranging and serious repercussions associated with it. Nocturia is one of the causes of sleep disturbance and has been shown to impair functioning, quality of life, health and productivity, with those experiencing two or more voids per night reporting significant ‘bother’. Nocturia warrants full consideration as a significant target for intervention, aiming to reduce the burden of disturbed sleep on individuals, families and society. Currently however, a definitive evaluation of the most relevant sleep endpoints in nocturia therapy is lacking. One endpoint often used is the duration of the initial sleep period, which when evaluated in combination with the number of voiding episodes per night might be an indication of the severity of sleep disruption in patients with nocturia.

show abstract

“…Moreover, failures of this homeostatic regulation are predicted to negatively affect organisms' well-being. Indeed, nocturia (bothersome waking-up at night to void) are known to decrease quality of life and negatively affect morbidity and mortality in human beings, especially in the elderly [5,6]. Researches also indicated that nocturia disrupts sleep architecture and predicts obstructive sleep apnea while acute sleep deprivation results in excess diuresis and natriuresis [7,8].…”

mentioning

confidence: 99%

“…In these efforts, key molecules linking circadian clock and voiding function should be clarified. Given the multifaceted nature of voiding function and dysfunction [5,9], however, all the possible alternatives need to be considered as well.…”

mentioning

confidence: 99%

Circadian Rhythms in Voiding Function and Dysfunction

2011

View full text Add to dashboard Cite

While circadian rhythms in fluid intake, urine production, and urine storage have been substantiated in diurnal human and nocturnal rodents, the mechanism(s) underlying it is largely unknown. With the elucidations of molecular clockwork and its functional significance in mammals, new opportunities arise to investigate possible circadian control of voiding function and dysfunction, which undoubtedly needs immediate attentions of researchers in the field.

show abstract

Antidiuresis therapy: Mechanism of action and clinical implications

Cited by 39 publications

References 77 publications

International Continence Society consensus on the diagnosis and treatment of nocturia

International Continence Society consensus on the diagnosis and treatment of nocturia

The effect of nocturia on sleep

Circadian Rhythms in Voiding Function and Dysfunction

Contact Info

Product

Resources

About