The role of urine osmolality and ions in the pathogenesis of primary enuresis nocturna and in the prediction of responses to desmopressin and conditioning therapies
Aim of the study was to determine the role of nocturnal and daytime urine volume, osmolality and ion excretions in the pathogenesis of primary monosymptomatic enuresis nocturna (PMEN) and in the prediction of response to desmopressin and conditioning therapies. Fifty-five children with PMEN between...
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| Veröffentlicht in: | International urology and nephrology 2005-12, Vol.37 (4), p.751-757 |
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| description | Aim of the study was to determine the role of nocturnal and daytime urine volume, osmolality and ion excretions in the pathogenesis of primary monosymptomatic enuresis nocturna (PMEN) and in the prediction of response to desmopressin and conditioning therapies. Fifty-five children with PMEN between the ages 5 and 15 years were included to the study. The patients were randomly divided into three groups Group 1: Twenty enuretics having intranasal desmopressin 1x 20 microg treatment for 2 months Group 2: Twenty enuretics having conditioning therapy for 2 months. Group 3: Fifteen enuretics having intranasal izotonic solutions as placebo. The control group consisted of 15 healthy children. Urine osmolality, sodium, potassium, chloride, magnesium and creatinine levels were investigated in both daytime and nighttime urines. Fractional sodium, potassium, magnesium, chloride excretions were calculated. Wilcoxon, Mann-Whitney U, Kruskal-Wallis, Chi-square, Student's t and Pearson correlation tests were performed. The ratio of night/daytime urine osmolality was significantly decreased in enuretic children. In addition, the ratio of night/daytime urine Cl and K excretions were also significantly decreased in enuretics. Response rate to desmopressin and conditioning treatments were statistically higher than placebo control. The difference between response rates of desmopressin and conditioning therapies was not found statistically significant. Pretreatment values of urine volume osmolality and ions were not observed as predictive factors in response to desmopressin or conditioning therapy. In conclusion, nightly decreased potassium and chloride excretions were found to have a role in the pathogenesis of primary enuresis nocturna. Urine volume, osmolality and ion excretions are not suggested to be used in the prediction of response to desmopressin and conditioning therapies. |
| doi_str_mv | 10.1007/s11255-005-1660-8 |
| format | Article |
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Fifty-five children with PMEN between the ages 5 and 15 years were included to the study. The patients were randomly divided into three groups Group 1: Twenty enuretics having intranasal desmopressin 1x 20 microg treatment for 2 months Group 2: Twenty enuretics having conditioning therapy for 2 months. Group 3: Fifteen enuretics having intranasal izotonic solutions as placebo. The control group consisted of 15 healthy children. Urine osmolality, sodium, potassium, chloride, magnesium and creatinine levels were investigated in both daytime and nighttime urines. Fractional sodium, potassium, magnesium, chloride excretions were calculated. Wilcoxon, Mann-Whitney U, Kruskal-Wallis, Chi-square, Student's t and Pearson correlation tests were performed. The ratio of night/daytime urine osmolality was significantly decreased in enuretic children. In addition, the ratio of night/daytime urine Cl and K excretions were also significantly decreased in enuretics. Response rate to desmopressin and conditioning treatments were statistically higher than placebo control. The difference between response rates of desmopressin and conditioning therapies was not found statistically significant. Pretreatment values of urine volume osmolality and ions were not observed as predictive factors in response to desmopressin or conditioning therapy. In conclusion, nightly decreased potassium and chloride excretions were found to have a role in the pathogenesis of primary enuresis nocturna. Urine volume, osmolality and ion excretions are not suggested to be used in the prediction of response to desmopressin and conditioning therapies.</description><identifier>ISSN: 0301-1623</identifier><identifier>EISSN: 1573-2584</identifier><identifier>DOI: 10.1007/s11255-005-1660-8</identifier><identifier>PMID: 16362593</identifier><identifier>CODEN: IURNAE</identifier><language>eng</language><publisher>Netherlands: Springer Nature B.V</publisher><subject>Adolescent ; Antidiuretic Agents - therapeutic use ; Behavior Therapy ; Child ; Chlorides - urine ; Deamino Arginine Vasopressin - therapeutic use ; Enuresis - drug therapy ; Enuresis - therapy ; Enuresis - urine ; Humans ; Osmolar Concentration ; Potassium - urine ; Prospective Studies ; Treatment Outcome</subject><ispartof>International urology and nephrology, 2005-12, Vol.37 (4), p.751-757</ispartof><rights>Springer 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c241t-450d060de6e11b97d156b45e0c875aab9b33190130e800a2aae69138ada9065f3</citedby><cites>FETCH-LOGICAL-c241t-450d060de6e11b97d156b45e0c875aab9b33190130e800a2aae69138ada9065f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16362593$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Unüvar, Tolga</creatorcontrib><creatorcontrib>Sönmez, Ferah</creatorcontrib><title>The role of urine osmolality and ions in the pathogenesis of primary enuresis nocturna and in the prediction of responses to desmopressin and conditioning therapies</title><title>International urology and nephrology</title><addtitle>Int Urol Nephrol</addtitle><description>Aim of the study was to determine the role of nocturnal and daytime urine volume, osmolality and ion excretions in the pathogenesis of primary monosymptomatic enuresis nocturna (PMEN) and in the prediction of response to desmopressin and conditioning therapies. Fifty-five children with PMEN between the ages 5 and 15 years were included to the study. The patients were randomly divided into three groups Group 1: Twenty enuretics having intranasal desmopressin 1x 20 microg treatment for 2 months Group 2: Twenty enuretics having conditioning therapy for 2 months. Group 3: Fifteen enuretics having intranasal izotonic solutions as placebo. The control group consisted of 15 healthy children. Urine osmolality, sodium, potassium, chloride, magnesium and creatinine levels were investigated in both daytime and nighttime urines. Fractional sodium, potassium, magnesium, chloride excretions were calculated. Wilcoxon, Mann-Whitney U, Kruskal-Wallis, Chi-square, Student's t and Pearson correlation tests were performed. The ratio of night/daytime urine osmolality was significantly decreased in enuretic children. In addition, the ratio of night/daytime urine Cl and K excretions were also significantly decreased in enuretics. Response rate to desmopressin and conditioning treatments were statistically higher than placebo control. The difference between response rates of desmopressin and conditioning therapies was not found statistically significant. Pretreatment values of urine volume osmolality and ions were not observed as predictive factors in response to desmopressin or conditioning therapy. In conclusion, nightly decreased potassium and chloride excretions were found to have a role in the pathogenesis of primary enuresis nocturna. Urine volume, osmolality and ion excretions are not suggested to be used in the prediction of response to desmopressin and conditioning therapies.</description><subject>Adolescent</subject><subject>Antidiuretic Agents - therapeutic use</subject><subject>Behavior Therapy</subject><subject>Child</subject><subject>Chlorides - urine</subject><subject>Deamino Arginine Vasopressin - therapeutic use</subject><subject>Enuresis - drug therapy</subject><subject>Enuresis - therapy</subject><subject>Enuresis - urine</subject><subject>Humans</subject><subject>Osmolar Concentration</subject><subject>Potassium - urine</subject><subject>Prospective Studies</subject><subject>Treatment Outcome</subject><issn>0301-1623</issn><issn>1573-2584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkcFu1TAQRS0Eoq-FD2CDLBbsAjNx7DhLVBWKVIlNWVtOMq91lWcHT7Lo__ChOLxISKxsec65ln2FeIfwCQHaz4xYa10B6AqNgcq-EAfUrapqbZuX4gAKsExqdSEumZ8AoLMAr8UFGmVq3amD-H3_SDKniWQ6yjWHWDZ8SpOfwvIsfRxlSJFliHIp4OyXx_RAkTjwJsw5nHx-lhTX_PcspmFZc_Rnc5cyjWFYSs6mFG4uicRySXKkcleZMxd2U4YUx7ChIT5scvZzIH4jXh39xPR2X6_Ez68399e31d2Pb9-vv9xVQ93gUjUaRjAwkiHEvmtH1KZvNMFgW-193_VKYQeogMo3-Np7Mh0q60ffgdFHdSU-nnPnnH6txIs7BR5omnyktLIztgNlbFPAD_-BT2l79sSuRoNWt60uEJ6hISfmTEe3f5dDcFt_7tyfK_25rT9ni_N-D177E43_jL0w9QdFdJkb</recordid><startdate>200512</startdate><enddate>200512</enddate><creator>Unüvar, Tolga</creator><creator>Sönmez, Ferah</creator><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>200512</creationdate><title>The role of urine osmolality and ions in the pathogenesis of primary enuresis nocturna and in the prediction of responses to desmopressin and conditioning therapies</title><author>Unüvar, Tolga ; Sönmez, Ferah</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c241t-450d060de6e11b97d156b45e0c875aab9b33190130e800a2aae69138ada9065f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adolescent</topic><topic>Antidiuretic Agents - therapeutic use</topic><topic>Behavior Therapy</topic><topic>Child</topic><topic>Chlorides - urine</topic><topic>Deamino Arginine Vasopressin - therapeutic use</topic><topic>Enuresis - drug therapy</topic><topic>Enuresis - therapy</topic><topic>Enuresis - urine</topic><topic>Humans</topic><topic>Osmolar Concentration</topic><topic>Potassium - urine</topic><topic>Prospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Unüvar, Tolga</creatorcontrib><creatorcontrib>Sönmez, Ferah</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International urology and nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Unüvar, Tolga</au><au>Sönmez, Ferah</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of urine osmolality and ions in the pathogenesis of primary enuresis nocturna and in the prediction of responses to desmopressin and conditioning therapies</atitle><jtitle>International urology and nephrology</jtitle><addtitle>Int Urol Nephrol</addtitle><date>2005-12</date><risdate>2005</risdate><volume>37</volume><issue>4</issue><spage>751</spage><epage>757</epage><pages>751-757</pages><issn>0301-1623</issn><eissn>1573-2584</eissn><coden>IURNAE</coden><abstract>Aim of the study was to determine the role of nocturnal and daytime urine volume, osmolality and ion excretions in the pathogenesis of primary monosymptomatic enuresis nocturna (PMEN) and in the prediction of response to desmopressin and conditioning therapies. Fifty-five children with PMEN between the ages 5 and 15 years were included to the study. The patients were randomly divided into three groups Group 1: Twenty enuretics having intranasal desmopressin 1x 20 microg treatment for 2 months Group 2: Twenty enuretics having conditioning therapy for 2 months. Group 3: Fifteen enuretics having intranasal izotonic solutions as placebo. The control group consisted of 15 healthy children. Urine osmolality, sodium, potassium, chloride, magnesium and creatinine levels were investigated in both daytime and nighttime urines. Fractional sodium, potassium, magnesium, chloride excretions were calculated. Wilcoxon, Mann-Whitney U, Kruskal-Wallis, Chi-square, Student's t and Pearson correlation tests were performed. The ratio of night/daytime urine osmolality was significantly decreased in enuretic children. In addition, the ratio of night/daytime urine Cl and K excretions were also significantly decreased in enuretics. Response rate to desmopressin and conditioning treatments were statistically higher than placebo control. The difference between response rates of desmopressin and conditioning therapies was not found statistically significant. Pretreatment values of urine volume osmolality and ions were not observed as predictive factors in response to desmopressin or conditioning therapy. In conclusion, nightly decreased potassium and chloride excretions were found to have a role in the pathogenesis of primary enuresis nocturna. Urine volume, osmolality and ion excretions are not suggested to be used in the prediction of response to desmopressin and conditioning therapies.</abstract><cop>Netherlands</cop><pub>Springer Nature B.V</pub><pmid>16362593</pmid><doi>10.1007/s11255-005-1660-8</doi><tpages>7</tpages></addata></record> |
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| subjects | Adolescent Antidiuretic Agents - therapeutic use Behavior Therapy Child Chlorides - urine Deamino Arginine Vasopressin - therapeutic use Enuresis - drug therapy Enuresis - therapy Enuresis - urine Humans Osmolar Concentration Potassium - urine Prospective Studies Treatment Outcome |
| title | The role of urine osmolality and ions in the pathogenesis of primary enuresis nocturna and in the prediction of responses to desmopressin and conditioning therapies |
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