Relationship between nocturnal polyuria and non‐dipping blood pressure in male patients with lower urinary tract symptoms

Takayama, Misato; Omori, So; Iwasaki, Katsurô; Shiomi, Ei; Takata, Ryo; Sugimura, Jun; Abe, Takaya; Obara, Wataru

doi:10.1111/luts.12225

Cited by 15 publications

(16 citation statements)

References 29 publications

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“…The small number of symptomatic participants in this study may be not suitable to analyze statistical difference. Also, we could not address the effect of obstructive sleep apnea symptoms on nocturia [32] and nocturnal polyuria [33, 34] because of the lack of information. Finally, our results may not be generalizable to other populations.…”

Section: Discussionmentioning

confidence: 99%

A Longitudinal Study of Bidirectional Relationships between Sleep Disorder and Frequency of Nocturia: Results from the Iwaki Health Promotion Project

et al. 2020

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Introduction: The causal relationship between sleep disorder and frequency of nocturia remains unclear. Methods: We longitudinally evaluated sleep disorder and frequency of nocturia in 547 community-dwelling adults between baseline and 5-year follow-up. We included participants ≥50 years old who have no sleep disorder (the Pittsburgh Sleep Quality Index [PSQI] ≥ 5) nor nocturia (≥1). For 5 years, we evaluated the temporal changes in sleep disorder and nocturia and the bidirectional relationships between sleep disorder and nocturia. Results: Of the 547 participants, we included 268 adults with a median age of 61 years in this study. Median PSQI and nocturia were significantly increased for 5 years from 2 to 3 and from 1 to 2, respectively. New onset of sleep disorder (PSQI > 5) and nocturia >1 was observed in 42 (16%) and 137 (51%) participants, respectively. The cross-lagged panel analysis showed that the path coefficient from PSQI to nocturia (β = 0.22, p = 0.031) was significantly higher than that from nocturia to PSQI (β = 0.02, p = 0.941). Conclusions: Our longitudinal study showed the effect of sleep disorder on nocturia was significant, although nocturia may not significantly worsen sleep disorder in community-dwelling adults.

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Section: Discussionmentioning

confidence: 99%

A Longitudinal Study of Bidirectional Relationships between Sleep Disorder and Frequency of Nocturia: Results from the Iwaki Health Promotion Project

et al. 2020

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“…There is an association between nondipping hypertension and nocturia, 44 and a specific association has been reported between NP and nondipping hypertension. 45 Children with enuresis have also been found to have higher nocturnal blood pressure than controls. 46 Nondipping hypertension is associated with increased morbidity.…”

Section: Cardiovascular Causes Of Nocturiamentioning

confidence: 99%

International Continence Society consensus on the diagnosis and treatment of nocturia

Everaert

Hervé

Bosch

et al. 2019

Neurourology and Urodynamics

109

104

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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.

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“…51 Other disorders that can mimic NPS by causing increased nocturnal urine output include congestive heart failure, autonomic failure with impaired ability to excrete water when upright (which may result in polyuria when recumbent at night), 51 and the loss of nocturnal dipping of blood pressure that may be a factor in NP. 52 The results of the recent study by Takayama et al suggest a relationship between nondipping blood pressure and NP, although they could not confirm the direction of the cause-and-effect relationship because of the many mechanisms that underlie nondipping blood pressure. 52 Enuresis and NPS share some pathophysiological similarities.…”

Section: Characteristics Of Npsmentioning

confidence: 91%

“…52 The results of the recent study by Takayama et al suggest a relationship between nondipping blood pressure and NP, although they could not confirm the direction of the cause-and-effect relationship because of the many mechanisms that underlie nondipping blood pressure. 52 Enuresis and NPS share some pathophysiological similarities. For example, an abnormal diurnal rhythm of AVP may be a factor in the development of enuresis, which would explain the high nocturnal urinary volume and the low nocturnal urinary osmolality in such patients.…”

Section: Characteristics Of Npsmentioning

confidence: 91%

Pathophysiological Mechanisms of Nocturia and Nocturnal Polyuria: The Contribution of Cellular Function, the Urinary Bladder Urothelium, and Circadian Rhythm

Birder

Kerrebroeck

2019

Urology

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Alterations to arginine vasopressin (AVP) secretion, the urinary bladder urothelium (UT) and other components of the bladder, and the water homeostasis biosystem may be relevant to the pathophysiology of nocturia and nocturnal polyuria (NP). AVP is the primary hormone involved in water homeostasis. Disruption to the physiological release of AVP or its target effects may relate to several urinary disturbances. Circadian dysregulation and the effects of aging, for example, the development of oxidative stress and mitochondrial dysfunction, may play a role in nocturia voiding symptoms.The urinary bladder UT not only acts as a highly efficient barrier that is maintained during the filling and voiding of the urinary bladder, but is also capable of sensory and transducer function through a network of functional receptors and ion channels that enable reciprocal communication between UT cells and neighboring elements of the bladder mucosa and wall. Functional components of the UT (eg, claudins and receptors or ion channels) play important roles in AVPmediated water homeostasis. These components and functions involved in water homeostasis, as well as kidney function, may be affected by the aging process, including age-related mitochondrial dysfunction.The characteristics of NP are discussed and the association between NP and circadian rhythm is examined in light of reports that suggest that nocturia should be considered as a type of circadian dysfunction.Many possible pathologic mechanisms that underlie nocturia and NP have been identified. Future studies may provide further insight into pathophysiology with the hope of identifying new treatment modalities. UROLOGY 133: 14−23, 2019.

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Relationship between nocturnal polyuria and non‐dipping blood pressure in male patients with lower urinary tract symptoms

Abstract: We suggest that treatment of non-dipping blood pressure may improve NP.

Cited by 15 publications

References 29 publications

A Longitudinal Study of Bidirectional Relationships between Sleep Disorder and Frequency of Nocturia: Results from the Iwaki Health Promotion Project

A Longitudinal Study of Bidirectional Relationships between Sleep Disorder and Frequency of Nocturia: Results from the Iwaki Health Promotion Project

International Continence Society consensus on the diagnosis and treatment of nocturia

Pathophysiological Mechanisms of Nocturia and Nocturnal Polyuria: The Contribution of Cellular Function, the Urinary Bladder Urothelium, and Circadian Rhythm

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