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Antidiuretic hormone regulation in patients with primary nocturnal enuresis

P Eggert1, B Kühn

  • 1Universitäts-Kinderklinik, Schwanenweg, Kiel, Germany.

Archives of Disease in Childhood
|December 1, 1995
PubMed

Insights

Children with primary nocturnal enuresis do not have lower nighttime antidiuretic hormone (ADH) secretion. Enuretic children require more ADH to regulate plasma osmolality, suggesting potential receptor-level differences.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Urology

Background:

  • Primary nocturnal enuresis is often treated with DDAVP, assuming insufficient nighttime antidiuretic hormone (ADH) secretion.
  • Doubts persist regarding the theoretical basis for DDAVP's efficacy in treating enuresis.

Purpose of the Study:

  • To investigate the hypothesis of insufficient nocturnal ADH secretion in children with primary nocturnal enuresis.
  • To compare urine production, ADH secretion, and plasma osmolality between enuretic children and controls.

Main Methods:

  • Compared 10 children with primary nocturnal enuresis to 8 age-matched controls.
  • Measured diurnal and nocturnal urine production, ADH secretion, and plasma osmolality in both groups.

Main Results:

  • No significant differences were found in urine production, daytime/nighttime ADH levels, or plasma osmolality between groups.
  • Enuretic children required significantly higher ADH output to regulate plasma osmolality compared to controls (p < 0.01).

Conclusions:

  • The findings contradict the hypothesis that lower ADH secretion causes increased nocturnal urine production in enuretics.
  • Results suggest a potential difference at the ADH receptor level in enuretic children, rather than a deficit in ADH secretion.

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