Desmopressin in elderly patients with nocturia: short‐term safety and effects on urine output, sleep and voiding patterns

Rembratt, Åsa; Nørgaard, Jens Peter; Andersson, Karl‐Erik

doi:10.1046/j.1464-410x.2003.04170.x

Cited by 46 publications

(27 citation statements)

References 17 publications

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“…The prevalence of hyponatremia found is similar to that described in a recent meta-analysis (Weatherall, 2004), which among other trials included the all male study in the present analysis. A previous trial in elderly indicated that the risk of desmopressin-induced hyponatremia increased with age, cardiac disease and increasing 24-hour urine volume (Rembratt et al, 2003). Patients with cardiac disease were excluded from the present trials, however, the findings on age and 24-hour urine volume were confirmed.…”

Section: Resultsmentioning

confidence: 68%

“…The incidence of hyponatremia reported in nocturia has been significantly higher, with 12-22% of patients experiencing one or more episodes of serum sodium concentration below normal range (Lose et al, 2003;Lose et al, 2004;Mattiasson et al, 2002;Rembratt et al, 2003). Serum sodium concentration has been assessed in many clinical trials involving desmopressin, but rarely as frequently as in the large nocturia trials published by Mattiasson et al and Lose et al Consequently, it is expected that these trials unearth a higher frequency of non-symptomatic low serum sodium concentration.…”

Section: Introductionmentioning

confidence: 99%

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Desmopressin treatment in nocturia; an analysis of risk factors for hyponatremia

Rembratt

Riis

Nørgaard

2005

Neurourology and Urodynamics

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109

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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.

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Section: Resultsmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Desmopressin treatment in nocturia; an analysis of risk factors for hyponatremia

Rembratt

Riis

Nørgaard

2005

Neurourology and Urodynamics

Self Cite

109

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“…Subjects with co-morbidity or medication use that could a¡ect serum sodium could have a di¡erent, and presumably higher, incidence of hyponatremia than the majority of subjects included in this analysis. Although it is reassuring that the Rembratt et al [2003] did include subjects who used diuretics and had other co-morbidity it is important to note that the follow up time for this study was only 3 days.…”

Section: Discussionmentioning

confidence: 99%

“…An important issue regarding whether this analysis can be generalised is that apart from one study [Rembratt et al, 2003] all of the studies included in the analysis excluded subjects who had cardiac or renal co-morbidity or used drugs, such as diuretics, that could a¡ect the serum sodium level. Subjects with co-morbidity or medication use that could a¡ect serum sodium could have a di¡erent, and presumably higher, incidence of hyponatremia than the majority of subjects included in this analysis.…”

Section: Discussionmentioning

confidence: 99%

The risk of hyponatremia in older adults using desmopressin for nocturia: A systematic review and meta‐analysis

Weatherall

2004

Neurourology and Urodynamics

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“…La hiponatremia puede originar diversos eventos adversos, desde cefalea leve, náuseas, vómitos y anorexia hasta pérdida de conciencia, convulsiones y la muerte. En un metaanálisis se ha comunicado que el riesgo de hiponatremia ronda el 7,6% 26 , y parece aumentar con la edad, las cardiopatías y un volumen alto de orina en 24 horas 27 .…”

Section: Desmopresinaunclassified

Guías EAU sobre incontinencia urinaria

et al. 2011

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Objetivo: El objetivo de este artículo es ofrecer un resumen de la actualización de las directrices sobre incontinencia urinaria (IU) de la EAU realizada en 2009. Recogida de evidencias: El comité de trabajo de la EAU formó parte de la IV Consulta Internacional sobre Incontinencia (ICI) y, con permiso de la ICI, llevó a cabo la extracción de la información de relevancia. La metodología de la IV ICI consistió en una amplia revisión de la literatura por parte de expertos internacionales y en la creación de un nivel de consenso. Asimismo, el nivel de evidencia se calificó de acuerdo con un sistema Oxford modificado y los grados de recomendación se atribuyeron en consonancia. Resumen de evidencias: Está disponible una versión completa de las directrices de la EAU sobre incontinencia urinaria en formato impreso (ampliada y en formato reducido), así como en formato de CD-ROM, pudiendo solicitarse a la oficina de la EAU o en línea en la dirección (http://www.uroweb.org/guidelines/online-guidelines/). La amplitud e invasividad de la evaluación de la IU depende de la gravedad y/o complejidad de los síntomas y signos clínicos, y es diferente para varones, mujeres, personas mayores de salud delicada, niños y pacientes con neuropatías. En el nivel de tratamiento inicial se aplican pruebas básicas de diagnóstico para descartar enfermedades o problemas subyacentes, tales como infecciones del tracto urinario. El tratamiento suele ser conservador (intervenciones en los hábitos de vida, fisioterapia, ଝ La traducción de este artículo se ha llevado a cabo con el permiso de la Asociación Europea de Urología.

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Desmopressin in elderly patients with nocturia: short‐term safety and effects on urine output, sleep and voiding patterns

Abstract: Desmopressin was well tolerated in elderly patients with nocturia, but the results suggest that serum sodium should be measured before and after a few days of treatment.

Cited by 46 publications

References 17 publications

Desmopressin treatment in nocturia; an analysis of risk factors for hyponatremia

Desmopressin treatment in nocturia; an analysis of risk factors for hyponatremia

The risk of hyponatremia in older adults using desmopressin for nocturia: A systematic review and meta‐analysis

Guías EAU sobre incontinencia urinaria

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