pituitrin and Nocturia

Topics: Humans; Male; Natriuretic Peptide, Brain; Nocturia; Polyuria; Sleep Apnea, Obstructive; Vasopressins

To investigate the impact of obstructive sleep apnea syndrome (OSAS) on night-time secretion of brain natriuretic peptide (BNP) and antidiuretic hormone (ADH) in older men with nocturia accompanied by nocturnal polyuria.. One hundred six men with nocturia aged ≥ 60 years underwent full-night polysomnography to determine whether they had OSAS. Blood count, standard chemistry panel, BNP, urinary ADH, urinary creatinine (u-Cre), and urinary osmolarity were measured at 6:00 AM, and a frequency volume chart was recorded on the same day that polysomnography was performed.. We evaluated 83 patients after excluding 18 with mild OSAS and 5 with nocturnal polyuria index <0.35. Participants with OSAS had higher apnea-hypopnea index (P < .0001) than those without OSAS. Body mass index and systolic blood pressure were higher in OSAS patients than those in the control group. BNP was higher in the OSAS patients than in the control patients (48.6 ± 41.4 vs 30.7 ± 31.5; P = .0006). On urinalysis, OSAS patients showed higher urinary sodium and u-Cre secretion than controls (24.7 ± 11.3 vs 16.2 ± 5.1; P <.0001). Urine osmolarity was also higher in OSAS patients than in the control patients (616 ± 172 vs 516 ± 174; P = .0285). There was no significant difference in urinary ADH and u-Cre (6.7 ± 10.4 vs 6.8 ± 7.8; P = .3617) between the 2 groups.. Our results indicated that older men with nocturnal polyuria and OSAS did not compensate their fluid imbalance presented with decreased secretion of ADH but increased BNP level.

Topics: Aged; Aged, 80 and over; Circadian Rhythm; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; Nocturia; Polyuria; Sleep Apnea, Obstructive; Vasopressins

Topics: Humans; Male; Natriuretic Peptide, Brain; Nocturia; Polyuria; Sleep Apnea, Obstructive; Vasopressins

Topics: Humans; Male; Natriuretic Peptide, Brain; Nocturia; Polyuria; Sleep Apnea, Obstructive; Vasopressins

To evaluate the relationship between leg edema, nocturnal urine volume (NUV), and the secretion of antidiuretic hormone (ADH) during the night, and to investigate the principal factors affecting nocturnal polyuria in older men.. A total of 74 male inpatients more than 50 years of age were enrolled in this study. Blood count, standard chemistry panel, brain natriuretic peptide (BNP), urinary ADH (u-ADH), urinary creatinine (u-Cre), and urinary osmolarity were measured at 6:00 am. Keeping a frequency volume chart, bioelectric impedance analysis was performed at 5 pm. Leg edema was measured as an edema ratio, using the following formula: extracellular water [L)/(extracellular water [L) + intracellular water [L)) in legs.. A total of 66 patients were evaluated. NUV had a significant positive correlation with leg edema (r = 0.32, P = .008), negative correlation with u-ADH/u-Cre (r = -0.37, P = .003) but not BNP. Leg edema had a significant positive correlation with the level of BNP (r = 0.33, P = .012) and negative correlation with u-ADH/u-Cre (r = -0.4, P = .001). However a partial correlation showed that there was no significant correlation between NUV and leg edema. A multivariate logistic model showed that only u-ADH/u-Cre was an independent predictive variable of nocturnal polyuria.. This study suggested that leg edema influenced nocturnal urine volume with an associated decrease in ADH secretion but not directly. ADH secretion during the night was the principal factor affecting NP in older men.

Topics: Aged; Blood Pressure; Edema; Heart Failure; Humans; Leg; Male; Middle Aged; Natriuretic Peptide, Brain; Nocturia; Osmolar Concentration; Polyuria; Vasopressins

Obstructive sleep apnea-hypopnea syndrome (OSAHS) in children with hypoxemia might influence the nocturnal secretion of antidiuretic hormone (ADH) that is associated with polyuria, even nocturia.. The impact of OSAHS on the secretion levels of ADH was studied in pediatric patients with adenotonsillar hypertrophy.. Forty-eight children (28 with OSAHS, 20 as normal controls) were recruited in this study. Respiratory indexes of all subjects were monitored by polysomnography and 12-h urinary volume was recorded during sleep. Vein blood was sampled to detect the levels of ADH in serum using a radioimmunoassay technique, both before and after adenotonsillectomy.. After surgery for OSAHS, the mean value of the apnea-hypopnea index (AHI) decreased (from 17.36±2.61 to 3.32±1.41, p<0.001), lowest arterial oxygen saturation (LSaO(2)) increased (from 78.34±13.44 to 95.35±6.24, p<0.001), urine volume (UV) in nocturnal 12 h reduced (from 492±90 to 332±56, p<0.001), and ADH level increased (from 63.08±35.15 to 83.10±21.05, p<0.05). The differences in UV and ADH between postoperative children and healthy controls were not statistically significant (both p>0.05).

Topics: Adenoidectomy; Case-Control Studies; Child; Female; Humans; Male; Nocturia; Polysomnography; Postoperative Period; Preoperative Period; Sleep Apnea, Obstructive; Tonsillectomy; Treatment Outcome; Vasopressins

We assessed the effects of long-term oral desmopressin on serum sodium and baseline antidiuretic hormone secretion in elderly patients with nocturia.. A total of 15 elderly male patients with severe nocturia (greater than 3 voids nightly) who did not show hyponatremia within 7 days of administration of 0.2 mg desmopressin were enrolled in this study. Desmopressin (0.2 mg) was administered orally nightly for 1 year. Before and 1 month after the 1-year medication 24-hour circadian studies were performed to monitor changes in antidiuretic hormone. Every 3 months during the 1-year medication serum changes and timed urine chemistry were monitored.. Desmopressin significantly decreased nocturnal urine output and the number of nocturia episodes (p<0.01). Compared to before treatment desmopressin gradually decreased serum sodium and induced statistically but not clinically significant hyponatremia after 6 months of treatment. After discontinuing desmopressin serum sodium returned to the normal range in all patients. There were no significant differences when baseline and posttreatment endogenous antidiuretic hormone were compared. No serious systemic complications were found during medication.. Long-term desmopressin administration gradually decreased the serum concentration and induced significant hyponatremia from 6 months in patients who did not show initial hyponatremia. Long-term administration of desmopressin for 1 year in elderly patients did not affect baseline antidiuretic hormone secretion. For long-term desmopressin administration serum sodium should be assessed regularly, at least every 6 months.

Topics: Aged; Aged, 80 and over; Antidiuretic Agents; Circadian Rhythm; Deamino Arginine Vasopressin; Humans; Middle Aged; Nocturia; Osmolar Concentration; Sodium; Vasopressins