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Increased nocturnal blood pressure in enuretic children with polyuria
Anne Kruse1, Birgitte Mahler, Soren Rittig
1Clinical Institute, University of Aarhus, Aarhus, Denmark.
Insights
Children with nocturnal enuresis and polyuria have higher nocturnal blood pressure. Nocturnal urine output correlates positively with nocturnal mean arterial pressure in these children.
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.
Purpose:
We investigated the association between nocturnal blood pressure and urine production in children with enuresis.
Materials And Methods:
A total of 39 consecutive children with a mean age of 9.8 years (range 6.2 to 14.9) with monosymptomatic nocturnal enuresis completed a bladder diary, including 2 weeks of basic documentation and 2 with desmopressin titration from 120 to 240 microg sublingually. Arterial blood pressure was measured every 30 minutes during 24 hours and during 4 additional nights using an ambulatory blood pressure monitor. Furthermore, 10 healthy children were recruited into the study who completed a bladder diary for 5 days while measuring arterial blood pressures with documentation of all intake and voided volumes.
Results:
Patients with nocturnal polyuria had significantly higher nocturnal mean arterial pressure than patients without polyuria and controls (p <0.05). Furthermore, a positive correlation was seen between nocturnal urine output and nocturnal mean arterial pressure (r = 0.32, p <0.001). Nocturnal urine output was significantly higher during wet nights than dry nights (p <0.001). However, no significant difference was found in mean arterial pressure between wet and dry nights.
Conclusions:
Nocturnal mean arterial pressure was significantly higher in children with enuresis with polyuria than in children without polyuria. There was a significant positive correlation between average nocturnal mean arterial pressure and nocturnal urine volume in the whole study. The association between nocturnal blood pressure and urine volume, and the role of blood pressure should be investigated in a larger group of children with enuresis who have nocturnal polyuria.
