Short-term effects of desmopressin on water and electrolyte excretion in adults with nocturnal polyuria.
OBJECTIVE
Increased calcium excretion due to desmopressin has been reported in children with nocturnal enuresis. Desmopressin is often used to treat adult patients with nocturnal polyuria. However, data on the effect of desmopressin on water/electrolyte excretion in adults are scarce. We present the short-term effects of desmopressin on water and electrolyte excretion in adult patients with nocturnal polyuria.


METHODS
A total of 16 male patients with nocturnal polyuria, mean age 76.3 years, received 0.1 or 0.2 mg desmopressin before sleep. Frequency volume chart was recorded, and daytime and nighttime urine samples were collected separately before and after desmopressin administration. Urinary excretions of sodium, potassium and calcium were determined, and compared before and after treatment with desmopressin.


RESULTS
Desmopressin significantly increased urine osmolality, decreased nocturnal total urine volume, reduced the ratio of nocturnal urine volume-to-whole day urine volume and decreased nocturnal voiding frequency. Nocturnal urinary excretion of calcium (mean 0.137 vs 0.169 mg/kg body weight per hour, p = 0.004) and whole day excretion of calcium (mean 165.9 vs 200.0 mg per day, p = 0.012) were increased after desmopressin treatment. Nocturnal urinary potassium excretion (mean 0.030 vs 0.025 mEq/kg body weight per hour, p = 0.030) and whole day potassium excretion (mean 40.7 vs 36.1 mEq per day, p = 0.017) were decreased by desmopressin treatment. However, desmopressin treatment did not significantly change urinary secretion of sodium and chloride at nighttime or for the whole day.


CONCLUSIONS
Desmopressin reduces nocturnal urine volume and nocturnal voiding frequency in male patients with nocturnal polyuria. However, increased calcium and decreased potassium excretion following desmopressin treatment deserve attention particularly when it is used on a long-term basis.
Chang
Yu-Lung
YL
Division of Urology, Department of Surgery, Taipei Veterans General Hospital and Department of Urology, National Yang-Ming University, School of Medicine, No. 201 Sec. 2 Shih-Pai Road, Taipei, Taiwan 11217.
Lin
Alex T L
AT
Chen
Kuang-Kuo
KK
D000368:Aged; D000369:Aged, 80 and over; D050034:Antidiuretic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D002118:Calcium / Q000652:urine; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage / Q000494:pharmacology*; D004334:Drug Administration Schedule; D004573:Electrolytes / Q000652:urine*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053158:Nocturia / Q000188:drug therapy / Q000652:urine*; D011141:Polyuria / Q000188:drug therapy / Q000652:urine*; D011188:Potassium / Q000652:urine; D012964:Sodium / Q000652:urine; D014882:Water-Electrolyte Balance / Q000187:drug effects*
D050034:Antidiuretic Agents; D004573:Electrolytes; D012964:Sodium; D003894:Deamino Arginine Vasopressin; D011188:Potassium; D002118:Calcium