Evaluating nocturnal polyuria in Japanese children with nocturnal enuresis

Area of Science:

• Pediatric Nephrology
• Urology
• Clinical Research

Background:

• Nocturnal polyuria (NP) is a common cause of enuresis in children.
• Existing diagnostic criteria for NP, such as Hoashi's, may not align with international standards like the International Children's Continence Society (ICCS) and Rittig's criteria.
• Understanding these discrepancies is crucial for accurate diagnosis and effective treatment.

Purpose of the Study:

• To evaluate if Japanese children with nocturnal polyuria (NP) meet Hoashi's, ICCS, or Rittig's criteria.
• To compare the effectiveness of 1-desamino-8-d-arginine vasopressin (DDAVP) based on these different NP diagnostic criteria.

Main Methods:

• Fifty-four Japanese enuretic patients with NP and normal bladder capacity were enrolled.
• Diagnostic criteria (Hoashi's, ICCS, Rittig's) were compared for NP diagnosis.
• The short-term efficacy of 8-week 1-desamino-8-d-arginine vasopressin (DDAVP) treatment was assessed and correlated with the diagnostic criteria.

Main Results:

• Only 17% of patients met both Hoashi's and ICCS criteria; 26% met Hoashi's and Rittig's criteria.
• Approximately 80% of patients did not meet NP definitions by ICCS or Rittig's criteria.
• No significant difference in DDAVP treatment effectiveness was observed across the different NP diagnostic criteria groups (73% vs. 50% for Hoashi's vs. ICCS; 71% vs. 62% for Hoashi's vs. Rittig's).

Conclusions:

• Hoashi's criteria identify a larger proportion of patients with NP compared to ICCS and Rittig's criteria.
• Despite diagnostic discrepancies, 1-desamino-8-d-arginine vasopressin (DDAVP) demonstrated comparable short-term efficacy across all evaluated criteria.
• Future definitions of NP should consider potential physical differences between Japanese and Western populations.