Increased nocturnal blood pressure in enuretic children with polyuria

Area of Science:

• Pediatric Nephrology
• Urology
• Cardiovascular Physiology

Background:

• Nocturnal enuresis is a common condition in children.
• Understanding the physiological factors associated with enuresis is crucial for effective management.
• The relationship between nocturnal urine production and cardiovascular parameters like blood pressure requires further investigation.

Purpose of the Study:

• To investigate the association between nocturnal blood pressure and urine production in children diagnosed with enuresis.
• To compare nocturnal blood pressure and urine output in children with and without nocturnal polyuria.
• To explore the correlation between nocturnal urine volume and nocturnal mean arterial pressure.

Main Methods:

• A cohort of 39 children with monosymptomatic nocturnal enuresis underwent bladder diary completion and desmopressin titration.
• Ambulatory blood pressure monitoring was conducted over 24 hours and during four additional nights.
• A control group of 10 healthy children also completed bladder diaries and had their blood pressure monitored.

Main Results:

• Children with nocturnal polyuria exhibited significantly higher nocturnal mean arterial pressure compared to those without polyuria and controls.
• A significant positive correlation was observed between nocturnal urine output and nocturnal mean arterial pressure (r = 0.32, p <0.001).
• Nocturnal urine output was substantially higher on wet nights than on dry nights, though mean arterial pressure did not differ significantly between wet and dry nights.

Conclusions:

• Nocturnal mean arterial pressure is elevated in children with enuresis accompanied by polyuria.
• A direct positive relationship exists between average nocturnal mean arterial pressure and nocturnal urine volume in the studied population.
• Further research in larger cohorts of children with enuresis and nocturnal polyuria is warranted to elucidate the role of blood pressure.