title: Plasma antidiuretic hormone levels in children with spina bifida.
abstract: OBJECTIVE
  Urological management of spina bifida patients is controversial. The goals of therapy of neurogenic bladder are continence, prevention of infections and preservation of urinary tract. Desmopressin has been recently used in a spina bifida population that is dry during the day (daytime continence was achieved with clean intermittent catheterization and anticholinergics) but wet at night. The aim of this study was to assess plasma antidiuretic hormone (ADH) levels in these children.
  
  
  METHODS
  The study included 24 patients, 11 males and 13 females (mean age 6.4 years) referred to the Spina Bifida Centre of the Catholic University of Rome, and 57 normal age-matched controls. Morning (07.30-08.00 h) plasma ADH levels were measured using a specific radioimmunoassay.
  
  
  RESULTS
  Plasma ADH levels (normal range 5-11 microg/l) did not differ between spina bifida population and healthy controls. Serum ADH had a mean of 6.8 microg/l in affected children and a mean of 7.4 microg/l in the controls.
  
  
  CONCLUSIONS
  We conclude that the use of desmopressin in children with spina bifida should be reserved only in patients with decreased secretion of ADH, or may be useful in patients with persistent nocturnal incontinence to reduce night wetting. Therefore, research with a larger population is needed.
authors.affiliation: Department of Paediatrics, Catholic University of Rome, Italy. pietro.ferrara@mailcity.com
authors.forename: Pietro
authors.initials: P
authors.lastname: Ferrara
authors.forename: Carmen
authors.initials: C
authors.lastname: D'Aleo
authors.forename: Antonio
authors.initials: A
authors.lastname: Ruggiero
authors.forename: Fabrizia Paolini
authors.initials: FP
authors.lastname: Paoletti
authors.forename: Mario Laura
authors.initials: ML
authors.lastname: Chiozza
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
authors.forename: Paolo
authors.initials: P
authors.lastname: Caione
authors.forename: Roberto
authors.initials: R
authors.lastname: Del Gado
authors.forename: Elio
authors.initials: E
authors.lastname: Salvaggio
mesh_terms: D002648:Child; D002675:Child, Preschool; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000097:blood; D011863:Radioimmunoassay; D016135:Spinal Dysraphism / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D014549:Urinary Incontinence / Q000150:complications; D014667:Vasopressins / Q000097:blood*
chemical_list: D014667:Vasopressins; D003894:Deamino Arginine Vasopressin