Nocturia in adults: draft New Zealand guidelines for its assessment and management in primary care.
Nocturia is a common bothersome condition. An ad hoc group of interested clinicians from a variety of backgrounds has developed draft guidelines for the assessment and management of this condition in primary care in New Zealand. The guidelines propose four steps in the assessment and management: clinical evaluation; simple investigations; assignment of a provisional diagnosis; and management based on the provisional diagnosis. For nocturnal polyuria-associated nocturia, the draft guidelines recommend that: lifestyle measures should be used as part of the management; if a patient complaining of nocturia has other features of overactive bladder, then bladder retraining and/or anticholinergics can be used; hypnosedatives should not be used to treat nocturia in older adults because of the increased risk of falls; loop diuretics given in the afternoon should be considered for the treatment; and desmopressin can be considered in the management of nocturnal polyuria associated nocturia but that it should be used cautiously in people aged over 65 because of the risk of hyponatraemia. A draft algorithm based on international guidelines is presented.
Weatherall
Mark
M
Rehabilitation Research and Teaching Unit, Department of Medicine, Wellington School of Medicine and Health Sciences, Otago University, Wellington. markw@wnmeds.ac.nz
Arnold
Ted
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D050034:Antidiuretic Agents / Q000627:therapeutic use; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D009520:New Zealand; D011141:Polyuria / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D011320:Primary Health Care / Q000379:methods* / Q000592:standards*; D001745:Urinary Bladder Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D014549:Urinary Incontinence / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D014555:Urination Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy* / Q000652:urine
D050034:Antidiuretic Agents; D004232:Diuretics; D018727:Muscarinic Antagonists; D003894:Deamino Arginine Vasopressin