title: Safety and efficacy of desmopressin for the treatment of nocturia in elderly patients: a cohort study.
abstract: OBJECTIVE
  Desmopressin is used widely to treat nocturnal polyuria (NP), but there is concern of hyponatremia especially in elderly patients. This study aimed to evaluate the safety and efficacy of long-term desmopressin treatment in elderly patients with NP.
  
  
  METHODS
  Patients who were ≥65 years old with NP were analyzed. All patients were started on 0.1 mg desmopressin, and the dose was escalated to 0.2 mg depending on patient symptoms. All patients were educated the mechanism of desmopressin. The voiding diary and serum sodium levels were evaluated at baseline, 3-7 days after starting treatment and every 3-6 months. Safety was evaluated by hyponatremia, hyponatremic symptoms and other adverse drug events. The mean changes in number of nocturia and nocturnal urine volume (NUV) were evaluated for efficacy.
  
  
  RESULTS
  A total of 68 patients were included. The mean age was 72.6 (66-85) years. The mean night-time frequency was 3.0 ± 1.8 day, and the mean serum sodium level was 141.2 ± 2.1 mEq/L at baseline. The mean follow-up period was 27.9 months. The mean decrease in serum sodium level was 1.3 ± 3.4 mEq/L at the last follow-up (p = 0.003). Hyponatremia incidence was 4.4 %, and all patients recovered by stopping medication. Severe adverse events were not observed. The mean night-time frequency had decreased by 2.1, and the NUV had decreased by 374.2 ± 261.3 mL at the last follow-up (p < 0.001).
  
  
  CONCLUSIONS
  Desmopressin at doses below 0.2 mg is safe and effective in elderly patients with NP if patients are well informed and are closely followed up.
authors.affiliation: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Miho
authors.initials: M
authors.lastname: Song
authors.forename: Bum Sik
authors.initials: BS
authors.lastname: Hong
authors.forename: Ji-Youn
authors.initials: JY
authors.lastname: Chun
authors.forename: Ji-Yeon
authors.initials: JY
authors.lastname: Han
authors.forename: Myung-Soo
authors.initials: MS
authors.lastname: Choo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050034:Antidiuretic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003894:Deamino Arginine Vasopressin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000139:chemically induced; D008297:Male; D053158:Nocturia / Q000188:drug therapy*; D012964:Sodium / Q000097:blood; D013997:Time Factors
chemical_list: D050034:Antidiuretic Agents; D012964:Sodium; D003894:Deamino Arginine Vasopressin