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• W2078962085 abstract "No AccessJournal of UrologyPediatric Urology1 Nov 2012Effect of Indomethacin on Desmopressin Resistant Nocturnal Polyuria and Nocturnal Enuresis Konstantinos Kamperis, Søren Rittig, Wendy F. Bower, and Jens C. Djurhuus Konstantinos KamperisKonstantinos Kamperis More articles by this author , Søren RittigSøren Rittig More articles by this author , Wendy F. BowerWendy F. Bower More articles by this author , and Jens C. DjurhuusJens C. Djurhuus More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.07.019AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the acute effect of indomethacin on renal water and solute handling in children with coexisting monosymptomatic nocturnal enuresis and desmopressin resistant nocturnal polyuria, and in healthy controls. Materials and Methods: A total of 23 subjects were recruited, consisting of 12 children with monosymptomatic nocturnal enuresis and nocturnal polyuria with partial or no response to desmopressin, and 11 age matched controls. Children completed a 48-hour inpatient study protocol consisting of fractional urine collections and blood samples. Sodium and water intake were standardized. During the second night a dose of 50 mg indomethacin was administered orally before bedtime. Diuresis, urine osmolalities, clearances and fractional excretions were calculated for sodium, potassium, urea, osmoles and solute-free water. Renin, angiotensin II, aldosterone and atrial natriuretic peptide were measured in plasma. Prostaglandin E2 was measured in urine. Results: Indomethacin markedly decreased the nocturnal sodium, urea and osmotic excretion in children with enuresis and controls. The overall effect on nocturnal urine output was inconsistent in the group with enuresis. Subjects in whom nocturnal diuresis was decreased following administration of indomethacin remained dry. Conclusions: Prostaglandin inhibition leads to antidiuresis, reducing the amount of sodium, urea and osmotic excretion in children with monosymptomatic nocturnal enuresis and desmopressin resistant nocturnal polyuria. The sodium regulating hormones do not seem to mediate these processes. The overall effect in desmopressin nonresponders with nocturnal polyuria is variable. The extent to which indomethacin can be applied in the treatment of enuresis needs further evaluation. References 1 : Abnormal diurnal rhythm of plasma vasopressin and urinary output in patients with enuresis. Am J Physiol1989; 256: F664. Google Scholar 2 : Circadian variation of plasma arginine vasopressin concentration, or arginine vasopressin in enuresis. Scand J Urol Nephrol Suppl1999; 202: 47. Google Scholar 3 : Drugs for nocturnal enuresis in children (other than desmopressin and tricyclics). 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Clin Pediatr (Phila)2009; 48: 410. Google Scholar 24 : Influence of prostaglandins on sodium transport of isolated medullary nephron segments. Am J Physiol1977; 232: F383. Google Scholar 25 : Luminal prostaglandin E receptors regulate salt and water transport in rabbit cortical collecting duct. Am J Physiol1995; 269: F257. Google Scholar 26 : Renal function and urinary prostanoid excretions in salt-depleted women: comparative effects of enalapril and indomethacin treatments. Prostaglandins Leukot Essent Fatty Acids1999; 60: 87. Google Scholar 27 : Increased urinary nitrite excretion in primary enuresis: effects of indomethacin treatment on urinary and serum osmolality and electrolytes, urinary volumes and nitrite excretion. BJU Int2002; 90: 294. Google Scholar 28 : Bioavailability of indomethacin in man. Ann Clin Res1974; 6: 44. Google Scholar 29 : Evidence for an in vivo antagonism between vasopressin and prostaglandin in the mammalian kidney. J Clin Invest1975; 56: 420. Google Scholar 30 : Regulation of renal urea transporters. J Am Soc Nephrol1999; 10: 635. Google Scholar Department of Pediatrics, Aarhus University Hospital, Skejby and Institute of Clinical Medicine, Aarhus University (JCD), Aarhus, Denmark© 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byDossche L, Raes A, Hoebeke P, De Bruyne P and Vande Walle J (2015) Circadian Rhythm of Glomerular Filtration and Solute Handling Related to Nocturnal EnuresisJournal of Urology, VOL. 195, NO. 1, (162-167), Online publication date: 1-Jan-2016.Baskin L (2012) This Month in Pediatric UrologyJournal of Urology, VOL. 188, NO. 5, (1651-1653), Online publication date: 1-Nov-2012. Volume 188Issue 5November 2012Page: 1915-1923 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.KeywordspolyuriadiureticsnatriuresisprostaglandinsosmoticAcknowledgmentsJane Knudsen provided technical assistance.MetricsAuthor Information Konstantinos Kamperis More articles by this author Søren Rittig More articles by this author Wendy F. Bower More articles by this author Jens C. Djurhuus More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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