title: Clinical characteristics, nocturnal antidiuretic hormone levels, and responsiveness to DDAVP of school children with primary nocturnal enuresis.
abstract: OBJECTIVE
  Decreased nocturnal antidiuretic hormone (ADH) excretion has been suggested to be a causative factor for PNE in children. We investigate the demographic characteristics and nocturnal ADH levels of children with PNE who attended a tertiary referral center and to determine their response to treatment with desamino-D-arginine vasopressin (DDAVP).
  
  
  METHODS
  We performed a retrospective study in 90 PNE children aged 6-12 years. We recorded the gender, height, weight, number of children per family, and psychosocial problems and compared these findings with the corresponding data obtained from a national survey. We also measured the nocturnal ADH levels and evaluated the response rate to DDAVP.
  
  
  RESULTS
  The number of PNE patients decreased with an increase in age. Enuresis was significantly associated with male gender (P = 0.044) and more number of children per family (P = 0.043). The rates of comorbidity with defecation problems, obesity, attention-deficit hyperactivity disorder (ADHD), and overweight were 36.7, 17.8, 12.2, and 10%, respectively. Although the prevalence of obesity and ADHD was higher among children with PNE, there was no significant difference between PNE patients and their prevalence in the community. The ADH levels at 2 a.m. and 8 a.m. were 0.87 ± 0.75 and 0.89 ± 0.76 pg/ml, respectively. In the 50 (55.5%) patients who received DDAVP treatment, the complete- and partial response rates were 86 and 14%, respectively.
  
  
  CONCLUSIONS
  Our data confirmed that PNE was predominant in boys and larger family, and similar to the findings for disease prevalence, the number of children seeking treatment tended to decrease with increasing age. Low ADH levels were recognized as a possible cause of PNE, thereby explaining the good response to DDAVP treatment in Taiwanese children with PNE.
authors: Division of Pediatric Nephrology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Jei-Wen
authors: JW
authors: Chang
authors: Ling-Yu
authors: LY
authors: Yang
authors: Tai-Wai
authors: TW
authors: Chin
authors: Hsin-Lin
authors: HL
authors: Tsai
mesh_terms: D000367:Age Factors; D050034:Antidiuretic Agents / Q000627:therapeutic use*; D002648:Child; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D053206:Nocturnal Enuresis / Q000097:blood* / Q000188:drug therapy* / Q000453:epidemiology; D009994:Osmolar Concentration; D012189:Retrospective Studies; D012727:Sex Characteristics; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome; D014667:Vasopressins / Q000097:blood*
chemical_list: D050034:Antidiuretic Agents; D014667:Vasopressins; D003894:Deamino Arginine Vasopressin