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Nocturnal polyuria is related to 24-hour diuresis and osmotic excretion in an enuresis population referred to a tertiary center

(2007) JOURNAL OF UROLOGY. 178(6). p.2630-2634
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Abstract
Purpose: Primary nocturnal enuresis is a heterogeneous disorder, causing a mismatch between overnight diuresis volume and functional bladder capacity. Despite increasing insights in pathogenesis, lack of efficacy of the available treatments is a major problem. We evaluated characteristics of bladder volume and diuresis rate in patients with nocturnal enuresis referred to a tertiary enuresis center. Materials and Methods: Noninvasive screening including maximal voided volume, 24-hour circadian rhythm of diuresis and osmotic excretion from 1,000 consecutive patients. Results: Of the patients referred as having monosymptomatic nocturnal enuresis 32% were subsequently classified as having nonmonosymptomatic nocturnal enuresis. Differences in bladder volume and nocturnal diuresis characteristics between the monosymptomatic nocturnal enuresis and nonmonosymptomatic nocturnal enuresis groups were minimal. Conclusions: The most common observation is a nocturnal diuresis volume greater than maximal voided volume, which in both groups can be caused by nocturnal polyuria or small bladder volume for patient age. The most striking observation is that the positive correlation between nocturnal diuresis volume rate and nocturnal osmotic excretion and 24-hour fluid intake is significantly higher than with the inversed urinary osmolality overnight, which is not only unexpected based on the theory of the primary suppression of vasopressin levels overnight, but also points to a more important role for nutritional and fluid intake than accepted, if not in the primary pathogenesis, then at least in therapy resistance.
Keywords
nutritional support, ENURETIC CHILDREN, CIRCADIAN-RHYTHM, HYPERCALCIURIA, DESMOPRESSIN, STANDARDIZATION, DYSFUNCTION, ADOLESCENTS, VASOPRESSIN, water-electrolyte balance, nocturnal enuresis, polyuria

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Chicago
Vande Walle, Johan, Caroline Vande Walle, PIETER VANSINTJAN, Ann De Guchtenaere, Ann Raes, Raymond AMG Donckerwolcke, Erik Van Laecke, et al. 2007. “Nocturnal Polyuria Is Related to 24-hour Diuresis and Osmotic Excretion in an Enuresis Population Referred to a Tertiary Center.” Journal of Urology 178 (6): 2630–2634.
APA
Vande Walle, J., Vande Walle, C., VANSINTJAN, P., De Guchtenaere, A., Raes, A., Donckerwolcke, R. A., Van Laecke, E., et al. (2007). Nocturnal polyuria is related to 24-hour diuresis and osmotic excretion in an enuresis population referred to a tertiary center. JOURNAL OF UROLOGY, 178(6), 2630–2634.
Vancouver
1.
Vande Walle J, Vande Walle C, VANSINTJAN P, De Guchtenaere A, Raes A, Donckerwolcke RA, et al. Nocturnal polyuria is related to 24-hour diuresis and osmotic excretion in an enuresis population referred to a tertiary center. JOURNAL OF UROLOGY. 2007;178(6):2630–4.
MLA
Vande Walle, Johan, Caroline Vande Walle, PIETER VANSINTJAN, et al. “Nocturnal Polyuria Is Related to 24-hour Diuresis and Osmotic Excretion in an Enuresis Population Referred to a Tertiary Center.” JOURNAL OF UROLOGY 178.6 (2007): 2630–2634. Print.
@article{414421,
  abstract     = {Purpose: Primary nocturnal enuresis is a heterogeneous disorder, causing a mismatch between overnight diuresis volume and functional bladder capacity. Despite increasing insights in pathogenesis, lack of efficacy of the available treatments is a major problem. We evaluated characteristics of bladder volume and diuresis rate in patients with nocturnal enuresis referred to a tertiary enuresis center.
Materials and Methods: Noninvasive screening including maximal voided volume, 24-hour circadian rhythm of diuresis and osmotic excretion from 1,000 consecutive patients.
Results: Of the patients referred as having monosymptomatic nocturnal enuresis 32\% were subsequently classified as having nonmonosymptomatic nocturnal enuresis. Differences in bladder volume and nocturnal diuresis characteristics between the monosymptomatic nocturnal enuresis and nonmonosymptomatic nocturnal enuresis groups were minimal.
Conclusions: The most common observation is a nocturnal diuresis volume greater than maximal voided volume, which in both groups can be caused by nocturnal polyuria or small bladder volume for patient age. The most striking observation is that the positive correlation between nocturnal diuresis volume rate and nocturnal osmotic excretion and 24-hour fluid intake is significantly higher than with the inversed urinary osmolality overnight, which is not only unexpected based on the theory of the primary suppression of vasopressin levels overnight, but also points to a more important role for nutritional and fluid intake than accepted, if not in the primary pathogenesis, then at least in therapy resistance.},
  author       = {Vande Walle, Johan and Vande Walle, Caroline and VANSINTJAN, PIETER and De Guchtenaere, Ann and Raes, Ann and Donckerwolcke, Raymond AMG and Van Laecke, Erik and Mauel, R and Dehoorne, Jo and Van Hoyweghen, E and Hoebeke, Piet},
  issn         = {0022-5347},
  journal      = {JOURNAL OF UROLOGY},
  keyword      = {nutritional support,ENURETIC CHILDREN,CIRCADIAN-RHYTHM,HYPERCALCIURIA,DESMOPRESSIN,STANDARDIZATION,DYSFUNCTION,ADOLESCENTS,VASOPRESSIN,water-electrolyte balance,nocturnal enuresis,polyuria},
  language     = {eng},
  number       = {6},
  pages        = {2630--2634},
  title        = {Nocturnal polyuria is related to 24-hour diuresis and osmotic excretion in an enuresis population referred to a tertiary center},
  url          = {http://dx.doi.org/10.1016/j.juro.2007.08.029},
  volume       = {178},
  year         = {2007},
}

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