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Nocturia : when the heart wakes you up at night

Laure Van de Steen (UGent) , Mohammad Hazique, Mauro Van den Ende (UGent) , George Bou Kheir (UGent) , François Hervé (UGent) , Tine De Backer (UGent) , Karel Everaert (UGent) , Jeffrey Weiss (UGent) and Jason Lazar (UGent)
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Abstract
BackgroundNocturia is a common and burdensome symptom that may reflect underlying cardiovascular dysfunction. While previous studies have linked nocturia to heart failure and fluid overload, direct hemodynamic evidence supporting this association remains limited.ObjectiveTo evaluate the relationship between left- and right-sided filling pressures, particularly pulmonary artery wedge pressure (PAWP) and right atrial (RA) pressure, and nocturia severity in a cohort of patients undergoing right heart catheterization.MethodsWe conducted a prospective observational study of 74 adult patients undergoing right heart catheterization with documented PAWP. Nocturia frequency was assessed via structured interview and modeled as an ordinal outcome. Spearman's correlation and ordinal logistic regression were used to examine associations between PAWP and nocturia severity. Additional analyses explored relationships with right-sided filling pressures (right atrial, right ventricular end-diastolic (RVEDP), and pulmonary artery (PA) pressures). Because of multicollinearity, we fit separate adjusted ordinal logistic models including one pressure variable at a time (PAWP, RA, PA and RVEDP), each adjusted for left ventricular ejection fraction (LVEF), diuretic use, and peripheral edema (where available).ResultsPAWP was significantly associated with nocturia severity (rho = 0.35, p = 0.003). In adjusted ordinal logistic regression, each 1 mmHg increase in PAWP was associated with a 7-10% higher odds of more frequent nighttime voiding. In separate multivariable models adjusted for LVEF, diuretic use, and peripheral edema both RA pressure (OR 1.15 per mmHg, p = 0.021) and RVEDP (OR 1.17 per mmHg, p = 0.002) were independently associated with greater nocturia severity, wereas PA pressure showed a trend (OR = 1.06 per mmHg, p = 0.078).ConclusionsBoth left- and right-sided ventricular filling pressures, particularly PAWP and RA pressure, are independently associated with nocturia severity in adjusted analyses. These findings support nocturia as a clinical marker of hemodynamic congestion, highlighting the importance of nocturia as a symptom of fluid overload and potential cardiac dysfunction.
Keywords
Nocturia, Pulmonary artery wedge pressure, Heart failure, Fluid overload, Cardiac catheterization, Hemodynamics, ATRIAL-NATRIURETIC-PEPTIDE

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MLA
Van de Steen, Laure, et al. “Nocturia : When the Heart Wakes You up at Night.” WORLD JOURNAL OF UROLOGY, vol. 44, no. 1, 2026, doi:10.1007/s00345-025-06183-2.
APA
Van de Steen, L., Hazique, M., Van den Ende, M., Bou Kheir, G., Hervé, F., De Backer, T., … Lazar, J. (2026). Nocturia : when the heart wakes you up at night. WORLD JOURNAL OF UROLOGY, 44(1). https://doi.org/10.1007/s00345-025-06183-2
Chicago author-date
Van de Steen, Laure, Mohammad Hazique, Mauro Van den Ende, George Bou Kheir, François Hervé, Tine De Backer, Karel Everaert, Jeffrey Weiss, and Jason Lazar. 2026. “Nocturia : When the Heart Wakes You up at Night.” WORLD JOURNAL OF UROLOGY 44 (1). https://doi.org/10.1007/s00345-025-06183-2.
Chicago author-date (all authors)
Van de Steen, Laure, Mohammad Hazique, Mauro Van den Ende, George Bou Kheir, François Hervé, Tine De Backer, Karel Everaert, Jeffrey Weiss, and Jason Lazar. 2026. “Nocturia : When the Heart Wakes You up at Night.” WORLD JOURNAL OF UROLOGY 44 (1). doi:10.1007/s00345-025-06183-2.
Vancouver
1.
Van de Steen L, Hazique M, Van den Ende M, Bou Kheir G, Hervé F, De Backer T, et al. Nocturia : when the heart wakes you up at night. WORLD JOURNAL OF UROLOGY. 2026;44(1).
IEEE
[1]
L. Van de Steen et al., “Nocturia : when the heart wakes you up at night,” WORLD JOURNAL OF UROLOGY, vol. 44, no. 1, 2026.
@article{01KECGB7EG78YTT2RVHMRK7YSD,
  abstract     = {{BackgroundNocturia is a common and burdensome symptom that may reflect underlying cardiovascular dysfunction. While previous studies have linked nocturia to heart failure and fluid overload, direct hemodynamic evidence supporting this association remains limited.ObjectiveTo evaluate the relationship between left- and right-sided filling pressures, particularly pulmonary artery wedge pressure (PAWP) and right atrial (RA) pressure, and nocturia severity in a cohort of patients undergoing right heart catheterization.MethodsWe conducted a prospective observational study of 74 adult patients undergoing right heart catheterization with documented PAWP. Nocturia frequency was assessed via structured interview and modeled as an ordinal outcome. Spearman's correlation and ordinal logistic regression were used to examine associations between PAWP and nocturia severity. Additional analyses explored relationships with right-sided filling pressures (right atrial, right ventricular end-diastolic (RVEDP), and pulmonary artery (PA) pressures). Because of multicollinearity, we fit separate adjusted ordinal logistic models including one pressure variable at a time (PAWP, RA, PA and RVEDP), each adjusted for left ventricular ejection fraction (LVEF), diuretic use, and peripheral edema (where available).ResultsPAWP was significantly associated with nocturia severity (rho = 0.35, p = 0.003). In adjusted ordinal logistic regression, each 1 mmHg increase in PAWP was associated with a 7-10% higher odds of more frequent nighttime voiding. In separate multivariable models adjusted for LVEF, diuretic use, and peripheral edema both RA pressure (OR 1.15 per mmHg, p = 0.021) and RVEDP (OR 1.17 per mmHg, p = 0.002) were independently associated with greater nocturia severity, wereas PA pressure showed a trend (OR = 1.06 per mmHg, p = 0.078).ConclusionsBoth left- and right-sided ventricular filling pressures, particularly PAWP and RA pressure, are independently associated with nocturia severity in adjusted analyses. These findings support nocturia as a clinical marker of hemodynamic congestion, highlighting the importance of nocturia as a symptom of fluid overload and potential cardiac dysfunction.}},
  articleno    = {{79}},
  author       = {{Van de Steen, Laure and Hazique, Mohammad and Van den Ende, Mauro and Bou Kheir, George and Hervé, François and De Backer, Tine and Everaert, Karel and Weiss, Jeffrey and Lazar, Jason}},
  issn         = {{0724-4983}},
  journal      = {{WORLD JOURNAL OF UROLOGY}},
  keywords     = {{Nocturia,Pulmonary artery wedge pressure,Heart failure,Fluid overload,Cardiac catheterization,Hemodynamics,ATRIAL-NATRIURETIC-PEPTIDE}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{8}},
  title        = {{Nocturia : when the heart wakes you up at night}},
  url          = {{http://doi.org/10.1007/s00345-025-06183-2}},
  volume       = {{44}},
  year         = {{2026}},
}

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