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Relación de la poliuria nocturna de los ancianos con la hipertensión esencial
1London School of Hygiene and Tropical Medicine, UK. paul.mckeigue@lshtm.ac.uk
Lancet (London, England)
|June 7, 2000
Resumen
La poliuria nocturna, común en los ancianos, implica una producción de orina inversa. Esta condición está relacionada con la hipertensión y puede deberse a defectos en la vía del óxido nítrico.
Área de la Ciencia:
- Nefrología Nefrología.
- Gerontología Gerontología.
- Urología Urología Urología.
Sus antecedentes:
- La poliuria nocturna, caracterizada por un aumento de la producción de orina durante la noche, es prevalente en los ancianos.
- A menudo se diagnostica erróneamente y se trata de manera inapropiada, como ocurre con la cirugía de próstata en los hombres.
- La poliuria nocturna está asociada con la nocturia y la hipertensión esencial.
Objetivo del estudio:
- Para investigar la fisiopatología de la poliuria nocturna en ancianos.
- Explorar la relación entre la poliuria nocturna y la hipertensión esencial.
- Proponer una hipótesis unificadora para sus determinantes compartidos.
Principales métodos:
- Análisis comparativo de la excreción nocturna de sodio y la depuración de agua libre en pacientes ancianos con poliuria nocturna versus controles.
- Revisión de la literatura existente sobre poliuria nocturna, nocturia y hipertensión esencial.
- Generación de hipótesis basadas en vínculos fisiopatológicos.
Principales resultados:
- Los pacientes ancianos con poliuria nocturna exhiben una mayor excreción nocturna de sodio en comparación con los controles.
- El aclaramiento nocturno de agua libre no difiere significativamente entre los pacientes y los controles.
- La poliuria nocturna se asocia constantemente con la hipertensión en diferentes grupos de edad.
Conclusiones:
- Los análogos de la vasopresina no se recomiendan para el tratamiento de la poliuria nocturna debido a los riesgos potenciales; la terapia diurética es una alternativa más segura.
- La poliuria nocturna y la hipertensión esencial pueden compartir mecanismos fisiopatológicos comunes.
- Se supone que un defecto en la vía del óxido nítrico contribuye a ambas condiciones, que implican una presión alterada-natriuresis y el manejo de sodio.
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