The Role of Urine Osmolality and Ions in the Pathogenesis of Primary Enuresis Nocturna and in the Prediction of Responses to Desmopressin and Conditioning Therapies |
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Authors: | Tolga?ünüvar Email author" target="_blank">Ferah?S?nmezEmail author |
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Institution: | (1) Department of Pediatric Nephrology, Medical Faculty, Adnan Menderes University, Aydin, Türkiye |
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Abstract: | Aim of the study was to determine the role of nocturnal and daytime urine volume, osmolality and ion excretions in the pathogenesis
of primary monosymptomatic enuresis nocturna (PMEN) and in the prediction of response to desmopressin and conditioning therapies.
Fifty-five children with PMEN between the ages 5 and 15 years were included to the study. The patients were randomly divided
into three groups Group 1: Twenty enuretics having intranasal desmopressin 1× 20 μg treatment for 2 months Group 2: Twenty
enuretics having conditioning therapy for 2 months. Group 3: Fifteen enuretics having intranasal izotonic solutions as placebo.
The control group consisted of 15 healthy children. Urine osmolality, sodium, potassium, chloride, magnesium and creatinine
levels were investigated in both daytime and nighttime urines. Fractional sodium, potassium, magnesium, chloride excretions
were calculated. Wilcoxon, Mann–Whitney U, Kruskal–Wallis, Chi-square, Student’s t and Pearson correlation tests were performed. The ratio of night/daytime urine osmolality was significantly decreased in
enuretic children. In addition, the ratio of night/daytime urine Cl and K excretions were also significantly decreased in
enuretics. Response rate to desmopressin and conditioning treatments were statistically higher than placebo control. The difference
between response rates of desmopressin and conditioning therapies was not found statistically significant. Pretreatment values
of urine volume osmolality and ions were not observed as predictive factors in response to desmopressin or conditioning therapy.
In conclusion, nightly decreased potassium and chloride excretions were found to have a role in the pathogenesis of primary
enuresis nocturna. Urine volume, osmolality and ion excretions are not suggested to be used in the prediction of response
to desmopressin and conditioning therapies. |
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Keywords: | Conditioning therapy Desmopressin Osmolality Primary enuresis nocturna Urinary ion excretion Urine volume |
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