title: The risk of hyponatremia with desmopressin use for nocturnal polyuria.
abstract: BACKGROUND
  Desmopressin is used for treating nocturnal polyuria, but hyponatremia is an associated concern in the elderly due to impaired urinary dilution. This study was undertaken to characterize hyponatremia occurring in adults using desmopressin for nocturnal polyuria.
  
  
  METHODS
  Data from 172 patients who were prescribed desmopressin for nocturnal polyuria at a urology clinic from September 2010 through February 2013 were retrospectively analyzed. Demographic and laboratory parameters were investigated to examine the risk factors for desmopressin-associated hyponatremia.
  
  
  RESULTS
  The average follow-up serum sodium measured 21 ± 22 days after using desmopressin was 138 ± 5 mmol/l. Hyponatremia (<135 mmol/l) was found in 24 patients (14%), and it was severe in 7 (<126 mmol/l). In the hyponatremic patients, serum sodium decreased by 11 ± 6 mmol/l. Patients with hyponatremia were older than those with normonatremia (78 ± 7 vs. 68 ± 9 years, p < 0.0001). The presence of either hyponatremia-predisposing comorbidities or concurrent medications was associated with hyponatremia. Patients with hyponatremia had lower basal hemoglobin (11 ± 2 vs. 13 ± 2 g/dl, p < 0.001) and serum sodium (139 ± 2 vs. 140 ± 2 mmol/l, p < 0.05) than those with normonatremia. Multivariate logistic regression after adjustment for basal serum sodium showed that advanced age (OR 1.15; 95% CI 1.03-1.27) and lower hemoglobin level (OR 0.64; 95% CI 0.43-0.94) were independently associated with hyponatremia.
  
  
  CONCLUSIONS
  Hyponatremia is not infrequently associated with desmopressin use. Those with advanced age (≥65 years) and lower hemoglobin are at risk of desmopressin-associated hyponatremia and need to be carefully monitored.
authors: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors: Eun Young
authors: EY
authors: Choi
authors: Joon-Sung
authors: JS
authors: Park
authors: Yong Tae
authors: YT
authors: Kim
authors: Sung Yul
authors: SY
authors: Park
authors: Gheun-Ho
authors: GH
authors: Kim
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D050034:Antidiuretic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D015897:Comorbidity; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007010:Hyponatremia / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D053158:Nocturia / Q000097:blood / Q000188:drug therapy*; D011141:Polyuria / Q000097:blood / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D012964:Sodium / Q000097:blood*
chemical_list: D050034:Antidiuretic Agents; D006454:Hemoglobins; D012964:Sodium; D003894:Deamino Arginine Vasopressin