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• W2006526972 abstract "No AccessJournal of UrologyPediatric urology1 Aug 2006Desmopressin Toxicity Due to Prolonged Half-Life in 18 Patients With Nocturnal Enuresis Jo L. Dehoorne, Ann M. Raes, Erik van Laecke, Piet Hoebeke, and Johan G. Vande Walle Jo L. DehoorneJo L. Dehoorne More articles by this author , Ann M. RaesAnn M. Raes More articles by this author , Erik van LaeckeErik van Laecke More articles by this author , Piet HoebekePiet Hoebeke More articles by this author , and Johan G. Vande WalleJohan G. Vande Walle More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(06)00299-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Desmopressin has been used extensively for primary nocturnal enuresis and it is associated with a low incidence of adverse effects. The only reported serious side effect is seizure or altered levels of consciousness resulting from water intoxication, which has been reported for the nasal spray. We describe 18 children with clinical symptoms of water intoxication due to the prolonged bioactivity of desmopressin nasal spray. Materials and Methods: We evaluated 18 patients with clinical suspicion of prolonged desmopressin bioactivity during treatment with intranasal desmopressin for primary nocturnal enuresis. The control group consisted of 50 children with primary nocturnal enuresis and proven nocturnal polyuria who were treated with the same desmopressin regimen. Results: All patients had prolonged maximal urinary concentration capacity and delayed restoration of daytime diluting capacity (p <0.01). Of the patients 15 had the characteristic clinical symptoms of water intoxication with vomiting, headache, decreased consciousness and hyponatremia. We suspect that these symptoms are secondary to prolonged desmopressin bioactivity. Conclusions: Prolonged desmopressin bioactivity may increase the risk of water intoxication. References 1 : Diurnal anti-diuretic-hormone levels in enuretics. J Urol1985; 134: 1029. Abstract, Google Scholar 2 : Desmopressin acetate and nocturnal enuresis: how much do we know?. Pediatrics1993; 92: 420. Google Scholar 3 : Nocturnal enuresis: an international evidence based management strategy. J Urol2004; 171: 2545. Link, Google Scholar 4 : Long-term treatment with desmopressin in children with primary monosymptomatic nocturnal enuresis: an open multicentre study. Br J Urol1998; 82: 704. Google Scholar 5 : Efficacy, safety and dosing of desmopressin for nocturnal enuresis in Europe. Clin Pediatr (Spec Ed)1993; : 19. Google Scholar 6 : Experience with the long-term use of desmopressin for nocturnal enuresis in children and adolescents. BJU Int2002; 89: 420. Google Scholar 7 : Hyponatremic seizures in a child treated with desmopressin to control enuresis. Clin Pediatr1993; 9: 566. Google Scholar 8 : Hyponatremia associated with desmopressin for the treatment of nocturnal polyuria. Urology2002; 60: 344. Google Scholar 9 : Side effects and complications of treatment with desmopressin for enuresis. J Natl Med Assoc1994; 86: 775. Google Scholar 10 : Estimating bladder capacity in children. Urology1983; 21: 248. Google Scholar 11 : Desamino-8-D-arginine vasopressin (DDAVP): pharmacology and clinical use. Drugs Today1988; 24: 509. Google Scholar 12 : 1-Deamino-8D-arginine vasopressin the treatment of central diabetes insipidus in childhood. J Pediatr1978; 92: 1011. Google Scholar 13 : Desmopressin in the management of nocturnal enuresis in children: a double blind study. Pediatrics1978; 62: 970. Google Scholar 14 : Pharmacokinetics of 1-desamino-8-D-arginine vasopressin after various routes of administration in healthy volunteers. Clin Endocrinol (Oxf)1993; 38: 177. Google Scholar 15 : Desmopressin in nocturnal enuresis. J Urol1991; 145: 818. Link, Google Scholar 16 : Hyponatremia in patients with nocturnal enuresis treated with DDAVP. Eur J Pediatr1996; 155: 959. Google Scholar 17 : Severe hyponatremia caused by intranasal desmopressin for nocturnal enuresis. Acta Paediatr1993; 82: 881. Google Scholar 18 : Intranasal administration of peptides: nasal deposition, biological response, and absorption of desmopressin. J Pharmacol Sci1986; 75: 1085. Google Scholar Pediatric Nephrology and Urology Department, University Hospital Gent, Ghent, Belgium© 2006 by American Urological AssociationFiguresReferencesRelatedDetailsCited byDe Guchtenaere A, Raes A, Vande Walle C, Hoebeke P, Van Laecke E, Donckerwolcke R and Vande Walle J (2018) Evidence of Partial Anti-Enuretic Response Related to Poor Pharmacodynamic Effects of Desmopressin Nasal SprayJournal of Urology, VOL. 181, NO. 1, (302-309), Online publication date: 1-Jan-2009.Van Herzeele C, Alova I, Evans J, Eggert P, Lottmann H, Nørgaard J and Vande Walle J (2009) Poor Compliance With Primary Nocturnal Enuresis Therapy May Contribute to Insufficient Desmopressin ResponseJournal of Urology, VOL. 182, NO. 4S, (2045-2049), Online publication date: 1-Oct-2009.Dehoorne J, Walle C, Vansintjan P, Raes A, De Guchtenaere A, Van Laecke E, Hoebeke P and Vande Walle J (2018) Characteristics of a Tertiary Center Enuresis Population, With Special Emphasis on the Relation Among Nocturnal Diuresis, Functional Bladder Capacity and Desmopressin ResponseJournal of Urology, VOL. 177, NO. 3, (1130-1137), Online publication date: 1-Mar-2007.Robson W, Leung A and Norgaard J (2018) The Comparative Safety of Oral Versus Intranasal Desmopressin for the Treatment of Children With Nocturnal EnuresisJournal of Urology, VOL. 178, NO. 1, (24-30), Online publication date: 1-Jul-2007.De Guchtenaere A, Vande Walle C, Van Sintjan P, Donckerwolcke R, Raes A, Dehoorne J, Van Laecke E, Hoebeke P and Vande Walle J (2018) Desmopressin Resistant Nocturnal Polyuria May Benefit From Furosemide Therapy Administered in the MorningJournal of Urology, VOL. 178, NO. 6, (2635-2639), Online publication date: 1-Dec-2007.Lane W and Robson M (2018) Editorial CommentJournal of Urology, VOL. 176, NO. 2, (758-758), Online publication date: 1-Aug-2006. Volume 176Issue 2August 2006Page: 754-758 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsbladdertoxicityhalf-lifeenuresisdeamino arginine vasopressinMetricsAuthor Information Jo L. Dehoorne More articles by this author Ann M. Raes More articles by this author Erik van Laecke More articles by this author Piet Hoebeke More articles by this author Johan G. Vande Walle More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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