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Fluid control in elderly patients with nocturia.

Osamu Natsume¹, Yoshiteru Kaneko, Akihide Hirayama

¹Department of Urology, Uda City Hospital, Uda, Nara, Japan. osnatsume@hotmail.com

International Journal of Urology : Official Journal of the Japanese Urological Association

|February 12, 2009

Summary

Aging adults with nocturnal polyuria may experience hypervolemia or vasoconstriction, suggesting altered non-osmotic control mechanisms impacting fluid balance.

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Area of Science:

Gerontology
Nephrology
Physiology

Background:

Nocturnal polyuria (NP) is a common condition in aging individuals, significantly impacting quality of life.
The underlying pathophysiology of NP, particularly concerning fluid and osmotic regulation, requires further elucidation.

Purpose of the Study:

To investigate the pathophysiology of nocturnal polyuria (NP) in aging patients.
To evaluate osmotic and volume control mechanisms in individuals with and without NP.

Main Methods:

Prospective study of 50 patients (mean age 67.7 years) with nocturia.
Classification into nocturnal polyuria (NP) and non-nocturnal polyuria (non-NP) groups using frequency-volume charts.
Hypertonic saline infusion test to assess osmotic and volume control.

Main Results:

NP group showed increased nocturnal diuretic rate; non-NP group showed decreased nocturnal diuretic rate.
Positive correlation between systolic blood pressure and nocturnal diuretic rate in NP patients.
Altered plasma osmolality and arginine vasopressin levels observed in NP patients post-saline loading.

Conclusions:

Patients with NP may exhibit hypervolemic or vasoconstrictive conditions.
Non-osmotic control plays a significant role in NP, with aging potentially diminishing osmotic control's contribution.
Findings suggest a complex interplay of fluid balance, blood pressure, and hormonal regulation in aging-related NP.