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Nocturnal polyuria is related to absent circadian rhythm of glomerular filtration rate

(2007) JOURNAL OF UROLOGY. 178(6). p.2626-2629
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Abstract
Purpose: Monosymptomatic nocturnal enuresis is frequently associated with nocturnal polyuria and low urinary osmolality during the night. Initial studies found decreased vasopressin levels associated with low urinary osmolality overnight. Together with the documented desmopressin response, this was suggestive of a primary role for vasopressin in the pathogenesis of enuresis in the absence of bladder dysfunction. Recent studies no longer confirm this primary role of vasopressin. Other pathogenetic factors such as disordered renal sodium handling, hypercalciuria, increased prostaglandins and/or osmotic excretion might have a role. So far, little attention has been given to abnormalities in the circadian rhythm of glomerular filtration rate. We evaluated the circadian rhythm of glomerular filtration rate and diuresis in children with desmopressin resistant monosymptomatic nocturnal enuresis and nocturnal polyuria. Materials and Methods: We evaluated 15 children (9 boys) 9 to 14 years old with monosymptomatic nocturnal enuresis and nocturnal polyuria resistant to desmopressin treatment. The control group consisted of 25 children (12 boys) 9 to 16 years old with monosymptomatic nocturnal enuresis without nocturnal polyuria. Results: Compared to the control population, children with nocturnal polyuria lost their circadian rhythm not only for diuresis and sodium excretion but also for glomerular filtration rate. Conclusions: Patients with monosymptomatic nocturnal enuresis and nocturnal polyuria lack a normal circadian rhythm for diuresis and sodium excretion, and the circadian rhythm of glomerular filtration rate is absent. This absence of circadian rhythm of glomerular filtration rate and/or sodium handling cannot be explained by a primary role of vasopressin, but rather by a disorder in circadian rhythm of renal glomerular and/or tubular functions.
Keywords
DIURESIS, HYPERCALCIURIA, VASOPRESSIN, EXCRETION, ENURESIS, ENURETIC CHILDREN, glomerular filtration rate, diuresis, polyuria, nocturnal enuresis, circadian rhythm, PATHOGENESIS

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Chicago
De Guchtenaere, Ann, Caroline Vande Walle, PIETER VANSINTJAN, Ann Raes, Raymond AMG Donckerwolcke, Erik Van Laecke, Piet Hoebeke, and Johan Vande Walle. 2007. “Nocturnal Polyuria Is Related to Absent Circadian Rhythm of Glomerular Filtration Rate.” Journal of Urology 178 (6): 2626–2629.
APA
De Guchtenaere, A., Vande Walle, C., VANSINTJAN, P., Raes, A., Donckerwolcke, R. A., Van Laecke, E., Hoebeke, P., et al. (2007). Nocturnal polyuria is related to absent circadian rhythm of glomerular filtration rate. JOURNAL OF UROLOGY, 178(6), 2626–2629.
Vancouver
1.
De Guchtenaere A, Vande Walle C, VANSINTJAN P, Raes A, Donckerwolcke RA, Van Laecke E, et al. Nocturnal polyuria is related to absent circadian rhythm of glomerular filtration rate. JOURNAL OF UROLOGY. 2007;178(6):2626–9.
MLA
De Guchtenaere, Ann, Caroline Vande Walle, PIETER VANSINTJAN, et al. “Nocturnal Polyuria Is Related to Absent Circadian Rhythm of Glomerular Filtration Rate.” JOURNAL OF UROLOGY 178.6 (2007): 2626–2629. Print.
@article{414415,
  abstract     = {Purpose: Monosymptomatic nocturnal enuresis is frequently associated with nocturnal polyuria and low urinary osmolality during the night. Initial studies found decreased vasopressin levels associated with low urinary osmolality overnight. Together with the documented desmopressin response, this was suggestive of a primary role for vasopressin in the pathogenesis of enuresis in the absence of bladder dysfunction. Recent studies no longer confirm this primary role of vasopressin. Other pathogenetic factors such as disordered renal sodium handling, hypercalciuria, increased prostaglandins and/or osmotic excretion might have a role. So far, little attention has been given to abnormalities in the circadian rhythm of glomerular filtration rate. We evaluated the circadian rhythm of glomerular filtration rate and diuresis in children with desmopressin resistant monosymptomatic nocturnal enuresis and nocturnal polyuria.
Materials and Methods: We evaluated 15 children (9 boys) 9 to 14 years old with monosymptomatic nocturnal enuresis and nocturnal polyuria resistant to desmopressin treatment. The control group consisted of 25 children (12 boys) 9 to 16 years old with monosymptomatic nocturnal enuresis without nocturnal polyuria.
Results: Compared to the control population, children with nocturnal polyuria lost their circadian rhythm not only for diuresis and sodium excretion but also for glomerular filtration rate.
Conclusions: Patients with monosymptomatic nocturnal enuresis and nocturnal polyuria lack a normal circadian rhythm for diuresis and sodium excretion, and the circadian rhythm of glomerular filtration rate is absent. This absence of circadian rhythm of glomerular filtration rate and/or sodium handling cannot be explained by a primary role of vasopressin, but rather by a disorder in circadian rhythm of renal glomerular and/or tubular functions.},
  author       = {De Guchtenaere, Ann and Vande Walle, Caroline and VANSINTJAN, PIETER and Raes, Ann and Donckerwolcke, Raymond AMG and Van Laecke, Erik and Hoebeke, Piet and Vande Walle, Johan},
  issn         = {0022-5347},
  journal      = {JOURNAL OF UROLOGY},
  keyword      = {DIURESIS,HYPERCALCIURIA,VASOPRESSIN,EXCRETION,ENURESIS,ENURETIC CHILDREN,glomerular filtration rate,diuresis,polyuria,nocturnal enuresis,circadian rhythm,PATHOGENESIS},
  language     = {eng},
  number       = {6},
  pages        = {2626--2629},
  title        = {Nocturnal polyuria is related to absent circadian rhythm of glomerular filtration rate},
  url          = {http://dx.doi.org/10.1016/j.juro.2007.08.028},
  volume       = {178},
  year         = {2007},
}

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