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Optimizing response to desmopressin in patients with monosymptomatic nocturnal enuresis

(2017) PEDIATRIC NEPHROLOGY. 32(2). p.217-226
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Abstract
Most patients with monosymptomatic nocturnal enuresis can be effectively treated with an enuresis alarm or antidiuretic therapy (desmopressin), depending on the pathophysiology of the condition in the individual patient. Desmopressin is first-line therapy for enuresis caused by nocturnal polyuria, an excessive urine output during the night. However, in a recent study, around one-third of patients thought to be resistant to desmopressin were subsequently treated effectively with desmopressin monotherapy in a specialist centre. The aim of this article is to review best practice in selecting patients for desmopressin treatment, as well as outline eight recommendations for maximizing the chances of treatment success in patients receiving desmopressin. The roles of formulation, dose, timing of administration, food and fluid intake, inter-individual variation in response, body weight, adherence, withdrawal strategies and combination therapies are discussed in light of the most recent research on desmopressin and enuresis. Possible reasons for suboptimal treatment response are explored and strategies to improve outcomes in patients for whom desmopressin is an appropriate therapy are presented. Through optimization of the treatment plan in primary and specialist care centres, the hope is that fewer patients with this distressing and often embarrassing condition will experience unnecessary delays in receiving appropriate care and achieving improvements.
Keywords
Desmopressin, Nocturnal enuresis, Best practices, Treatment outcome, Treatment resistance, FUNCTIONAL BLADDER CAPACITY, INTRANASAL DESMOPRESSIN, LYOPHILISATE MELT, ALARM TREATMENT, WET NIGHTS, CHILDREN, POLYURIA, TABLET, SAFETY, ADOLESCENTS

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Citation

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MLA
Kamperis, Konstantinos et al. “Optimizing Response to Desmopressin in Patients with Monosymptomatic Nocturnal Enuresis.” PEDIATRIC NEPHROLOGY 32.2 (2017): 217–226. Print.
APA
Kamperis, K., Van Herzeele, C., Rittig, S., & Vande Walle, J. (2017). Optimizing response to desmopressin in patients with monosymptomatic nocturnal enuresis. PEDIATRIC NEPHROLOGY, 32(2), 217–226.
Chicago author-date
Kamperis, Konstantinos, Charlotte Van Herzeele, Soren Rittig, and Johan Vande Walle. 2017. “Optimizing Response to Desmopressin in Patients with Monosymptomatic Nocturnal Enuresis.” Pediatric Nephrology 32 (2): 217–226.
Chicago author-date (all authors)
Kamperis, Konstantinos, Charlotte Van Herzeele, Soren Rittig, and Johan Vande Walle. 2017. “Optimizing Response to Desmopressin in Patients with Monosymptomatic Nocturnal Enuresis.” Pediatric Nephrology 32 (2): 217–226.
Vancouver
1.
Kamperis K, Van Herzeele C, Rittig S, Vande Walle J. Optimizing response to desmopressin in patients with monosymptomatic nocturnal enuresis. PEDIATRIC NEPHROLOGY. 2017;32(2):217–26.
IEEE
[1]
K. Kamperis, C. Van Herzeele, S. Rittig, and J. Vande Walle, “Optimizing response to desmopressin in patients with monosymptomatic nocturnal enuresis,” PEDIATRIC NEPHROLOGY, vol. 32, no. 2, pp. 217–226, 2017.
@article{7224063,
  abstract     = {Most patients with monosymptomatic nocturnal enuresis can be effectively treated with an enuresis alarm or antidiuretic therapy (desmopressin), depending on the pathophysiology of the condition in the individual patient. Desmopressin is first-line therapy for enuresis caused by nocturnal polyuria, an excessive urine output during the night. However, in a recent study, around one-third of patients thought to be resistant to desmopressin were subsequently treated effectively with desmopressin monotherapy in a specialist centre. The aim of this article is to review best practice in selecting patients for desmopressin treatment, as well as outline eight recommendations for maximizing the chances of treatment success in patients receiving desmopressin. The roles of formulation, dose, timing of administration, food and fluid intake, inter-individual variation in response, body weight, adherence, withdrawal strategies and combination therapies are discussed in light of the most recent research on desmopressin and enuresis. Possible reasons for suboptimal treatment response are explored and strategies to improve outcomes in patients for whom desmopressin is an appropriate therapy are presented. Through optimization of the treatment plan in primary and specialist care centres, the hope is that fewer patients with this distressing and often embarrassing condition will experience unnecessary delays in receiving appropriate care and achieving improvements.},
  author       = {Kamperis, Konstantinos and Van Herzeele, Charlotte and Rittig, Soren and Vande Walle, Johan},
  issn         = {0931-041X},
  journal      = {PEDIATRIC NEPHROLOGY},
  keywords     = {Desmopressin,Nocturnal enuresis,Best practices,Treatment outcome,Treatment resistance,FUNCTIONAL BLADDER CAPACITY,INTRANASAL DESMOPRESSIN,LYOPHILISATE MELT,ALARM TREATMENT,WET NIGHTS,CHILDREN,POLYURIA,TABLET,SAFETY,ADOLESCENTS},
  language     = {eng},
  number       = {2},
  pages        = {217--226},
  title        = {Optimizing response to desmopressin in patients with monosymptomatic nocturnal enuresis},
  url          = {http://dx.doi.org/10.1007/s00467-016-3376-7},
  volume       = {32},
  year         = {2017},
}

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