title: Abnormal circadian blood pressure regulation in children with nocturnal enuresis.
abstract: BACKGROUND
  To investigate autonomic nervous system function in enuretic children by performing ambulatory blood pressure monitor (ABPM) for 24 h.
  
  
  METHODS
  Twenty-eight children ranging in age from 6 to 15 years with primary nocturnal enuresis and 27 age-matched healthy controls were enrolled and they get 24 h ABPM. Hypertension was defined as standard deviation score (SDS) > 1.64 (i.e., >95th percentile) adjusted for gender and height. Urinalysis, urine electrolyte levels, urinary culture, and urinary system ultrasound were carried out in all children. They have also requested to have a diary about daily fluid intake and urine volume.
  
  
  RESULTS
  Although the mean 24-h and daytime diastolic blood pressure (BP) did not differ between the groups, systolic BP (SBP) was significantly higher in enuretic children (p < 0.05). The mean night-time SBP, DBP values, SDS and BP loads were found to be significantly higher than those in the controls (p < 0.01). A lack of nocturnal decrease was more prevalent in the enuretic children compared with the control subjects, the difference was statistically significant for DBP but not for SBP. Patients with elevated night-time BP load was found to have higher frequency of urinary incontinence per week as well as per night when compared with enuretic children with normal night-time BP load (r = 0.72, r = 0.69, p < 0.01, respectively).
  
  
  CONCLUSIONS
  Subtle abnormalities of circadian BP regulation in enuretic children indicated by a selective elevation of nocturnal SBP, DBP, and MAP, and attenuated nocturnal dipping may reflect sympathetic hyper activation and its possible role in pathogenesis of enuresis.
authors.affiliation: a Department of Pediatric Nephrology , University of Başkent , Ankara , Turkey.
authors.forename: Özge
authors.initials: Ö
authors.lastname: Yüce
authors.affiliation: a Department of Pediatric Nephrology , University of Başkent , Ankara , Turkey.
authors.forename: Umut Selda
authors.initials: US
authors.lastname: Bayrakçi
authors.affiliation: a Department of Pediatric Nephrology , University of Başkent , Ankara , Turkey.
authors.forename: Kaan
authors.initials: K
authors.lastname: Gülleroğlu
authors.affiliation: a Department of Pediatric Nephrology , University of Başkent , Ankara , Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Baskın
mesh_terms: D000293:Adolescent; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D002648:Child; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D053206:Nocturnal Enuresis / Q000453:epidemiology*; D012307:Risk Factors
keywords: Ambulatory blood pressure monitor; autonomic nervous system activity; blood pressure; enuresis nocturna; hypertension