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Renal concentrating capacity test using desmopressin at bedtime
S Mårild1, A Rembratt, U Jodal
1Department of Pediatrics, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
Pediatric Nephrology (Berlin, Germany)
|June 19, 2001
Summary
Bedtime administration of desmopressin offers a simple and effective renal concentrating capacity test (RCCT) for children. This night-time method is preferred by patients and parents over the standard daytime test.
Area of Science:
- Pediatric Nephrology
- Clinical Pharmacology
Background:
- Assessing renal concentrating capacity is crucial for diagnosing renal impairment in children.
- Standard renal concentrating capacity tests (RCCTs) can be cumbersome and less preferred by patients.
Purpose of the Study:
- To evaluate the efficacy and patient preference of bedtime intranasal desmopressin as a renal concentrating capacity test (RCCT) in children.
- To compare the night-time desmopressin RCCT with the standard daytime RCCT.
Main Methods:
- A crossover trial involving 58 children (ages 3-15) with suspected or known renal impairment.
- Administration of a single 20-microgram intranasal dose of desmopressin at bedtime.
- Comparison of urine osmolality and patient/parent preference between night-time and standard daytime RCCTs.
Main Results:
- The night-time desmopressin test demonstrated higher mean osmolality (60 mosmol/kg) compared to the daytime test.
- Results were reproducible, with a 95% confidence interval of -26 to 43 mosmol/kg.
- A significant preference for the night-time regimen was reported by 51 of 52 patients or their parents.
Conclusions:
- Bedtime intranasal desmopressin is a simple, effective, and user-friendly method for assessing renal concentrating capacity in children.
- This approach offers a more convenient alternative to standard daytime RCCTs for evaluating suspected renal tubular function impairment.