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Identifying men with global polyuria on a nocturnal-only voiding diary.

Thomas F Monaghan1, Syed N Rahman1, Donald L Bliwise2

  • 1Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York.

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Summary

Nocturnal polyuria (NP) and global polyuria (GP) can coexist. High nocturnal urine volume (NUV) in NP patients is a sensitive indicator for comorbid GP, potentially simplifying diagnosis.

Keywords:
adherenceglobal polyurianocturianocturnal polyuriasensitivityspecificity

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Area of Science:

  • Urology
  • Nephrology

Background:

  • Nocturnal polyuria (NP) and global polyuria (GP) are distinct conditions affecting urine production.
  • Diagnostic criteria for GP are generally more stringent than for NP.
  • The relationship between total nocturnal urine volume (NUV) and comorbid GP in NP patients requires clarification.

Purpose of the Study:

  • To determine if total nocturnal urine volume (NUV) can reliably differentiate NP patients with and without comorbid global polyuria (GP).
  • To assess the sensitivity of NUV in identifying comorbid GP in patients with nocturnal polyuria.

Main Methods:

  • Retrospective analysis of voiding diaries from men with lower urinary tract symptoms and at least one nocturnal void.
  • Patients meeting NP criteria were stratified based on the presence or absence of GP using established criteria.
  • Four distinct analytical combinations of NP and GP criteria were employed.

Main Results:

  • Median NUV was consistently higher in patients with both NP and GP (NP+GP) compared to those with isolated NP.
  • Specific NUV thresholds demonstrated high sensitivity (≥80%) for detecting NP+GP across different criterion combinations.
  • For instance, NUV ≥1275 mL indicated NP+GP with 80% sensitivity when using NPi > 0.33 and 24-hour volume > 3000 mL criteria.

Conclusions:

  • Elevated NUV in patients with NP is a sensitive marker for the presence of comorbid GP.
  • Nocturnal-only voiding diaries may be sufficient for evaluating and managing NP patients.
  • Outlying nocturnal volumes should prompt further 24-hour urine collection to confirm or rule out comorbid GP.