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Enuresis subtypes based on nocturnal hypercalciuria: a multicenter study.

Gabriella Aceto1, Rosa Penza, Maria Susanna Coccioli

  • 1Department of Biomedicina Età Evolutiva, University, Bari, Italy.

The Journal of Urology
|September 23, 2003
PubMed
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Nocturnal hypercalciuria is common in children with enuresis and linked to nighttime polyuria and low antidiuretic hormone (ADH) levels. This suggests a need for new classifications to guide effective treatment for bedwetting.

Area of Science:

  • Pediatric Nephrology
  • Urology
  • Endocrinology

Background:

  • Nocturnal enuresis affects many children, with treatments like desmopressin sometimes proving ineffective.
  • Polyuria and hypercalciuria are suspected contributors to persistent nocturnal enuresis.

Purpose of the Study:

  • To investigate the prevalence of nighttime hypercalciuria in enuretic children.
  • To determine the correlation between nighttime hypercalciuria and nighttime polyuria.

Main Methods:

  • 450 enuretic children underwent 72-hour micturition monitoring, urinalysis, and blood tests.
  • Urine and plasma samples were analyzed for electrolytes, osmolarity, and vasopressin (ADH).
  • Patients were classified based on the presence of nocturnal polyuria and hypercalciuria (urinary calcium/creatinine ratio > 0.21).

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Main Results:

  • Nighttime polyuria was observed in 65% of patients.
  • Nocturnal hypercalciuria was present in 39.7% of all children, significantly higher in those with nocturnal polyuria.
  • Low ADH levels were found in 81.5% of enuretics with nocturnal hypercalciuria, showing a significant correlation.

Conclusions:

  • Nocturnal hypercalciuria is a significant factor in nocturnal enuresis, associated with low ADH and nighttime polyuria.
  • A revised classification of nocturnal enuresis based on nighttime calciuria is necessary for tailored treatment approaches.