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首页> 外文期刊>American Journal of Physiology >Nocturnal polyuria in monosymptomatic nocturnal enuresis refractory to desmopressin treatment.
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Nocturnal polyuria in monosymptomatic nocturnal enuresis refractory to desmopressin treatment.

机译：夜间多尿症在单症状性夜间遗尿症中难以应用去氨加压素治疗。

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摘要

The transition from day to night is associated with a pronounced decline in diuresis with reductions in the amount of excreted water, electrolytes, and other end products of our metabolism. Failure to do so leads to a large urine output at night, a condition known as nocturnal polyuria, encountered in a large proportion of children with nocturnal enuresis. The aim of this study was to clarify the mechanisms responsible for the nocturnal polyuria seen in enuretics with inadequate response to desmopressin (dDAVP). Forty-six enuretics (7-14 yr of age) and fifteen age-matched controls were admitted for a 24-h protocol with standardized fluid and sodium intake, comprising urine collections, blood sampling, and blood pressure monitoring. We included patients with severe enuresis (5 +/- 1 wet nights/wk) showing <50% reduction in wet nights on dDAVP. We characterized the patients on the basis of their nocturnal urine production. The children with nocturnal polyuria excreted larger amounts of sodium and urea atnight than nonpolyurics and controls. Solute-free water reabsorption as well as urinary arginine vasopressin and aquaporin-2 excretion were normal in polyurics, and no differences were found in atrial natriuretic peptide, angiotensin II, aldosterone, and renin levels. Urinary prostaglandin E2 (PGE2) excretion was significantly higher in polyurics. The nocturnal polyuria in children with dDAVP-resistant nocturnal enuresis seems to be the result of augmented sodium and urea excretion. The high urinary PGE2 levels found in these children point toward a role for increased prostaglandin synthesis in the pathogenesis of enuresis-related polyuria.
机译：从白天到黑夜的转变与利尿作用的显着下降有关，尿液的排泄水，电解质和其他新陈代谢终产物的量减少。未能做到这一点会导致夜间有大量尿液排出，这种情况被称为夜间多尿症，在大部分患有夜间遗尿症的儿童中都会遇到。这项研究的目的是弄清楚在对去氨加压素（dDAVP）反应不充分的遗尿症患者中，夜间多尿的原因。接受了46个输尿管（年龄为7-14岁）和15个年龄匹配的对照组的24小时方案，采用标准化的液体和钠摄入量，包括尿液收集，血液采样和血压监测。我们纳入了具有严重遗尿症（5 +/- 1个湿夜/周）的患者，这些患者的dDAVP湿夜减少了<50％。我们根据夜间尿液的产生对患者进行了特征描述。与非多尿症患者和对照组相比，夜间多尿症的儿童夜间排泄了大量的钠和尿素。在多尿症患者中，无溶质水的重吸收以及尿精氨酸加压素和水通道蛋白2的排泄是正常的，而心房利钠肽，血管紧张素II，醛固酮和肾素水平没有差异。尿尿中前列腺素E2（PGE2）的排泄量明显更高。耐dDAVP的夜间遗尿症患儿的夜间多尿症似乎是钠和尿素排泄增加的结果。在这些儿童中发现的高尿液PGE2水平表明，在遗尿症相关性多尿症的发病机理中，前列腺素合成增加的作用。

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