title: Reducing nocturia in the elderly: a randomized placebo-controlled trial of staggered furosemide and desmopressin.
abstract: OBJECTIVE
  The purpose of this study was to investigate efficacy, safety, and impact on quality of sleep of staggered furosemide and desmopressin in the treatment of nocturia in the elderly.
  
  
  METHODS
  Patients aged >60 years with nocturia at least two voids per night were screened for enrollment into the study. A 3-week dose-titration phase established the optimum desmopressin dose (0.1, 0.2, or 0.4 mg). After a 1-week "washout" period, patients who showed sufficient response during the dose-titration period were randomized to receive staggered furosemide and the optimal dose of desmopressin or placebo in a double-blind design for 3 weeks. Voiding diaries were assessed before and after the treatment.
  
  
  RESULTS
  In all, 82 patients were randomized to either staggered furosemide and desmopressin (n=41) or placebo (n=41). In the study group, most patients reported a good response with both reduced nocturnal voids (3.5 vs. 2.0, P<0.01) and urine volume (919.6 ml vs. 584.2 ml, P<0.01). The mean duration of the first sleep period was improved by 70 min (133.6 vs. 203.2, P<0.01). Compared to placebo, staggered furosemide and desmopressin resulted in a significant reduction in the mean number of nocturnal voids (43% vs. 9%; P<0.01), nocturnal urine volume (37% vs. 5%; P<0.01), and increase in the mean duration of the first sleep period (52% vs. 19%, P<0.01). Adverse events were mild.
  
  
  CONCLUSIONS
  Staggered furosemide and desmopressin provide an effective and well-tolerated treatment for nocturia in the elderly.
authors.affiliation: Department of Urology, TongJi Hospital, TongJi University School of Medicine, Shanghai, China.
authors.forename: Fei-Guo
authors.initials: FG
authors.lastname: Fu
authors.forename: Hugh J
authors.initials: HJ
authors.lastname: Lavery
authors.forename: Deng-Long
authors.initials: DL
authors.lastname: Wu
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage* / Q000009:adverse effects; D004232:Diuretics / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005665:Furosemide / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D053158:Nocturia / Q000188:drug therapy* / Q000503:physiopathology; D015990:Placebo Effect; D012890:Sleep / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D014563:Urodynamics / Q000187:drug effects
chemical_list: D004232:Diuretics; D005665:Furosemide; D003894:Deamino Arginine Vasopressin