Desmopressin response in nocturnal enuresis without nocturnal polyuria in Japanese children
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Published on: August 28, 2020
Shohei Akagawa1, Shoji Tsuji1, Yuko Akagawa1
1Department of Pediatrics, Kansai Medical University, Hirakata, Osaka, Japan.
Insights
Desmopressin effectively treats nocturnal enuresis in children. Its efficacy remains consistent whether or not children experience nocturnal polyuria, indicating it
Area of Science:
- Pediatric Urology
- Sleep Medicine
- Pharmacology
Background:
- Monosymptomatic nocturnal enuresis is common in children.
- Nocturnal polyuria is a potential factor influencing treatment outcomes.
- Desmopressin is a first-line treatment for nocturnal enuresis.
Purpose of the Study:
- To determine if desmopressin's efficacy varies between children with and without nocturnal polyuria.
- To compare desmopressin effectiveness based on different nocturnal polyuria diagnostic criteria.
Main Methods:
- 65 treatment-naïve children with monosymptomatic nocturnal enuresis were studied.
- Desmopressin was administered as the initial treatment.
- Nocturnal polyuria was assessed using four established standards; treatment response was defined as >50% reduction in wet nights.
Main Results:
- Desmopressin efficacy rates showed no statistically significant difference between children with and without nocturnal polyuria across all four assessed standards.
- Efficacy rates ranged from 45-54% for polyuria patients and 59-68% for non-polyuria patients.
- P-values ranged from 0.08 to 0.80, indicating no significant difference.
Conclusions:
- Short-term clinical efficacy of desmopressin for nocturnal enuresis is not affected by the presence of nocturnal polyuria.
- Desmopressin is a viable treatment option for children with nocturnal enuresis, irrespective of nocturnal polyuria status.
- Further research may explore long-term outcomes and specific patient subgroups.
Objectives:
To evaluate whether the efficacy of desmopressin differs between patients with and without nocturnal polyuria.
Methods:
A total of 65 treatment-naïve children with monosymptomatic nocturnal enuresis were enrolled (45 boys; median age 8.9 years). Patients received desmopressin as their first-line treatment. Four different standards were used (Akashi and Hoashi >0.9 mL/kg/sleeping hour; Hamano >[age + 2] × 25 × 130% mL; the International Children's Continence Society >[age + 1] × 30 × 130% mL; and Rittig >[age + 9] × 20 mL) to assess nocturnal polyuria. The effectiveness of desmopressin was compared between patients with and without nocturnal polyuria according to each standard. A response was defined as a reduction in wet nights of >50%.
Results:
The desmopressin treatment efficacy rate was 54% for polyuria and 67% for non-polyuria patients (P = 0.20), 45% for polyuria and 68% for non-polyuria patients (P = 0.08), 54% for polyuria and 59% for non-polyuria patients (P = 0.80), and 52% for polyuria and 61% for non-polyuria patients (P = 0.61), for the Akashi and Hoashi's, Hamano's, International Children's Continence Society and Rittig's standards, respectively.
Conclusions:
No difference was observed in the short-term clinical efficacy of desmopressin regardless of the presence of nocturnal polyuria. Thus, this might be a feasible treatment option for patients with nocturnal enuresis without nocturnal polyuria.
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