title: Reduced anti-diuretic response to desmopressin during wet nights in patients with monosymptomatic nocturnal enuresis.
abstract: OBJECTIVE
  To investigate why not all children with monosymptomatic nocturnal enuresis (MNE) treated with desmopressin give an adequate response.
  
  
  METHODS
  We included 114 children with MNE aged 5-15 years (9.8 ± 0.2 years) who experienced at least 1 wet night and more than 2 dry nights during desmopressin treatment. The patients made home recordings for 2 weeks as baseline and for 2-4 weeks of desmopressin titration. Nocturnal urine production during wet and dry nights, and maximum voided volumes (MVVs) were documented in all patients.
  
  
  RESULTS
  Sixty-four patients were desmopressin non-responders, 29 were either partial responders or responders, while 21 patients were full responders. Desmopressin reduced nocturnal urine production dramatically during dry nights compared with pre-treatment wet nights. Nocturnal urine production during desmopressin treatment was significantly greater during wet nights compared to dry nights (243 ± 9.32 vs 176 ± 5.31 ml, P < 0.001). There was a highly significant correlation between individual nocturnal urine output and MVV, and dry nights were characterized by nocturnal urine output/MVV ratios well below 1.0.
  
  
  CONCLUSIONS
  The anti-enuretic response to desmopressin seems to be dependent upon the degree of reduction in nocturnal urine production. Research on desmopressin bioavailability in children is needed.
authors.affiliation: Department of Paediatrics, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Århus N, Denmark. lhjelle@dadlnet.dk
authors.forename: Lene Hjelle
authors.initials: LH
authors.lastname: Tauris
authors.forename: Rene Frydensbjerg
authors.initials: RF
authors.lastname: Andersen
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kamperis
authors.forename: Søren
authors.initials: S
authors.lastname: Hagstroem
authors.forename: Søren
authors.initials: S
authors.lastname: Rittig
mesh_terms: D000293:Adolescent; D050034:Antidiuretic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D001682:Biological Availability; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004361:Drug Tolerance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D053206:Nocturnal Enuresis / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014554:Urination / Q000187:drug effects*
chemical_list: D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin