J Korean Med Sci.  2010 Dec;25(12):1792-1797. 10.3346/jkms.2010.25.12.1792.

Desmopressin is an Effective Treatment for Mixed Nocturia with Nocturnal Polyuria and Decreased Nocturnal Bladder Capacity

• Lee HW
• Choo MS
• Lee JG
• Park CH
• Paick JS
• Lee JZ
• Han DH
• Park WH
• Lee KS

• KMID: 1792905
• DOI: http://doi.org/10.3346/jkms.2010.25.12.1792

Abstract

To investigate the efficacy and safety of desmopressin in patients with mixed nocturia, Patients aged > or =18 yr with mixed nocturia (> or =2 voids/night and a nocturnal polyuria index [NPi] >33% and a nocturnal bladder capacity index [NBCi] >1) were recruited. The optimum dose of oral desmopressin was determined during a 3-week dose-titration period and the determined dose was maintained for 4 weeks. The efficacy was assessed by the frequency-volume charts and the sleep questionnaire. The primary endpoint was the proportion of patients with a 50% or greater reduction in the number of nocturnal voids (NV) compared with baseline. Among 103 patients enrolled, 94 (79 men and 15 women) were included in the analysis. The proportion of patients with a 50% or greater reduction in NV was 68 (72%). The mean number of NV decreased significantly (3.20 to 1.34) and the mean nocturnal urine volume, nocturia index, NPi, and NBCi decreased significantly. The mean duration of sleep until the first NV was prolonged from 118.4+/-44.1 to 220.3+/-90.7 min (P<0.001). The overall impression of patients about their quality of sleep improved. Adverse events occurred in 6 patients, including one asymptomatic hyponatremia. Desmopressin is an effective and well-tolerated treatment for mixed nocturia.

Keyword

Urinary Bladder; Deamino Arginine Vasopressin; Hyponatremia; Nocturia; Nocturnal Polyuria

MeSH Terms

Administration, Oral
Adult
Aged
Aged, 80 and over
Antidiuretic Agents/*administration & dosage
Deamino Arginine Vasopressin/*administration & dosage
Drug Administration Schedule
Female
Humans
Male
Middle Aged
Nocturia/complications/*drug therapy
Polyuria/complications/*drug therapy
Prospective Studies
Questionnaires
Sleep/drug effects/physiology
Urinary Bladder/*physiopathology
Urodynamics/physiology

Figure

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  Fig. 1 The study design and treatment schedule. NBCi, nocturnal bladder capacity index; NPi, nocturnal polyuria index; NUV, nocturnal urine volume.

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  Fig. 2 Disposition of patients. AE, adverse event; F/U, follow-up.

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  Fig. 3 The effect of desmopressin on the quality of sleep. (A) The duration of the first sleep period. (B) The proportion of more than 5 hr of undisturbed initial sleep per night. (C) The overall patient impression about his/her quality of sleep.

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