Plasma antidiuretic hormone levels in children with spina bifida.
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.
Ferrara
Pietro
P
Department of Paediatrics, Catholic University of Rome, Italy. pietro.ferrara@mailcity.com
D'Aleo
Carmen
C
Ruggiero
Antonio
A
Paoletti
Fabrizia Paolini
FP
Chiozza
Mario Laura
ML
Plebani
Mario
M
Caione
Paolo
P
Del Gado
Roberto
R
Salvaggio
Elio
E
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*
D014667:Vasopressins; D003894:Deamino Arginine Vasopressin