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Decrease in nocturnal urinary levels of arginine vasopressin in patients with nocturnal polyuria.

Akihide Hirayama1, Kiyohide Fujimoto, Tatsuya Akiyama

  • 1Department of Urology, Nara Medical University, Kasihara, Nara, Japan. hirayamn@nmu-gw.naramed-u.ac.jp

Urology
|June 30, 2006
PubMed
Summary

Low urinary arginine vasopressin (AVP) levels in the morning may cause nocturnal polyuria. Measuring urinary AVP/creatinine offers a noninvasive screening method for AVP insufficiency and nocturia.

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Area of Science:

  • Endocrinology
  • Nephrology
  • Urology

Background:

  • Nocturnal polyuria, characterized by excessive nighttime urination, significantly impacts quality of life.
  • The role of arginine vasopressin (AVP) and its circadian rhythm in nocturnal polyuria requires further elucidation.
  • Understanding the association between heart function, endocrine levels, and voided volume is crucial for managing nocturia.

Purpose of the Study:

  • To investigate the relationship between heart function, arginine vasopressin (AVP) levels, and nocturnal voided volume.
  • To determine if urinary AVP can serve as a screening marker for nocturnal polyuria due to AVP insufficiency.
  • To explore the association between solute diuresis and nocturnal voided volume.

Main Methods:

  • Fifty patients were enrolled, with blood and urine samples collected every 6 hours.

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  • Measurements included atrial natriuretic peptide, brain natriuretic peptide, electrolytes, osmolarity, and creatinine.
  • Urinary AVP and creatinine levels were analyzed to assess AVP insufficiency and circadian rhythm.

    • Main Results:

    • Patients with nocturnal polyuria showed significantly lower urinary AVP/urinary creatinine and urine osmolarity at midnight and 6 AM.
    • No significant differences were observed in cardiac biomarkers or plasma AVP between groups.
    • Nocturnal voided volume strongly correlated with urinary AVP/urinary creatinine levels obtained at midnight and 6 AM.

    Conclusions:

    • A decrease in urinary AVP/urinary creatinine levels in the early morning contributes to increased nocturnal voided volume and nocturia.
    • Circadian rhythm disorders of AVP can be predicted through noninvasive urinary AVP/urinary creatinine testing.
    • Urinary AVP/creatinine ratio is a potential biomarker for screening nocturnal polyuria caused by AVP insufficiency.