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• W2515697861 abstract "No AccessJournal of UrologyAdult Urology1 Feb 2017Circadian Rhythms in Water and Solute Handling in Adults with a Spinal Cord Injury Marie-Astrid Denys, Annick Viaene, An-Sofie Goessaert, Friedl Van Haverbeke, Piet Hoebeke, Ann Raes, and Karel Everaert Marie-Astrid DenysMarie-Astrid Denys Department of Urology, Ghent University Hospital, Ghent, Belgium Financial interest and/or other relationship with Astellas, Allergan, Bard, Medtronic and Ferring. Equal study contribution. More articles by this author , Annick ViaeneAnnick Viaene Department of Physical Medicine and Orthopedic Surgery, Ghent University Hospital, Ghent, Belgium Equal study contribution. More articles by this author , An-Sofie GoessaertAn-Sofie Goessaert Department of Urology, Ghent University Hospital, Ghent, Belgium More articles by this author , Friedl Van HaverbekeFriedl Van Haverbeke Department of Urology, AZ Nikolaas, Sint-Niklaas, Belgium More articles by this author , Piet HoebekePiet Hoebeke Department of Urology, Ghent University Hospital, Ghent, Belgium More articles by this author , Ann RaesAnn Raes Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium More articles by this author , and Karel EveraertKarel Everaert Department of Urology, Ghent University Hospital, Ghent, Belgium More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.08.001AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated nocturnal urine production and circadian rhythms of renal function (glomerular filtration, and water and solute diuresis) in adults with spinal cord injury compared to controls. Materials and Methods: This prospective observational study was done at Ghent University Hospital, Belgium. Participants were asked to perform a 24-hour urine collection. A blood sample was taken to calculate the diuresis rate and the renal clearance of creatinine, free water, solutes, sodium and urea. Results: A total of 119 patients were divided into 32 with spinal cord injury, and 68 controls with and 19 without nocturnal polyuria. Spinal cord injured patients showed no circadian rhythms in the diuresis rate or in the renal clearance of creatinine, free water, solutes, sodium or urea. Controls without nocturnal polyuria reported a lower nighttime diuresis rate and lower nighttime clearance of creatinine, solutes, sodium and urea compared to daytime levels. Controls with nocturnal polyuria had no circadian rhythms in the diuresis rate or creatinine clearance and a significant increase in nocturnal free water clearance compared to daytime levels. Conclusions: Comparing the mechanisms underlying nocturnal urine production between patients with spinal cord injury and controls revealed important differences. Spinal cord injured patients showed absent circadian rhythms in the renal clearance of creatinine (glomerular filtration), free water (water diuresis) and solutes such as sodium and urea (solute diuresis). Future research must be done to evaluate the role of patient stratification to find the most effective and safe treatment or combination of treatments for spinal cord injured patients with complaints or complications related to nocturnal polyuria. References 1 : The effect of nocturia on sleep. Sleep Med Rev2011; 15: 91. Google Scholar 2 : Persistent polyuria in a rat spinal contusion model. J Neurotrauma2012; 29: 2490. Google Scholar 3 : A retrospective review of the ambulatory blood pressure patterns and diurnal urine production in subgroups of spinal cord injured patients. Spinal Cord2015; 53: 49. Google Scholar 4 : Principles of Renal Physiology, 5th ed. New York: Springer2012. Google Scholar 5 : Orthostatic hypotension and paroxysmal hypertension in humans with high spinal cord injury. Prog Brain Res2006; 152: 231. Google Scholar 6 : Antidiuretic hormone levels and polyuria in spinal cord injury. A preliminary report. Paraplegia1995; 33: 94. Google Scholar 7 : Nocturnal polyuria and antidiuretic hormone levels in spinal cord injury. Arch Phys Med Rehabil1997; 78: 455. Google Scholar 8 : The use of desmopressin in the management of nocturnal enuresis in patients with spinal cord injury. Eura Medicophys2007; 43: 333. Google Scholar 9 : Diurnal variation of antidiuretic hormone and urinary output in spinal cord injury. Spinal Cord1999; 37: 332. Google Scholar 10 : Diagnosing the pathophysiologic mechanisms of nocturnal polyuria. Eur Urol2015; 67: 283. Google Scholar 11 : Orthostatic hypotension following spinal cord injury: understanding clinical pathophysiology. Spinal Cord2006; 44: 341. Google Scholar 12 : Exploring nocturia: gender, age, and causes. Neurourol Urodyn2015; 34: 561. Google Scholar 13 : The standardization of terminology in nocturia: report from the standardization subcommittee of the International Continence Society. BJU Int2002; 90: 11. Google Scholar 14 : Maximal bladder capacity is a positive predictor of response to desmopressin treatment in patients with MS and nocturia. Int Urol Nephrol2008; 40: 65. Google Scholar 15 : Abnormal diurnal rhythm of urine output following renal transplantation: the impact of blood pressure and diuretics. Transplant Proc2010; 42: 3529. Google Scholar 16 : Relation of nocturnal polyuria of the elderly to essential hypertension. Lancet2000; 355: 486. Google Scholar 17 : A clinical investigation of nocturnal polyuria in patients with nocturia: a diurnal variation in arginine vasopressin secretion and its relevance to mean blood pressure. J Urol2006; 176: 660. Link, Google Scholar 18 : Would a new definition and classification of nocturia and nocturnal polyuria improve our management of patients? ICI-RS 2014. Neurourol Urodyn2016; 35: 283. Google Scholar 19 : Nocturnal polyuria: it's all about definition, and be patient!. Eur Urol2013; 63: 548. Google Scholar © 2017 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byGriebling T (2018) Re: Pathophysiology of Nocturnal Lower Urinary Tract Symptoms in Older Patients with Urinary IncontinenceJournal of Urology, VOL. 200, NO. 4, (676-676), Online publication date: 1-Oct-2018. Volume 197Issue 2February 2017Page: 445-451 Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.Keywordspolyurianeurogenicurinary bladdercircadian rhythmspinal cord injuriesnocturiaMetricsAuthor Information Marie-Astrid Denys Department of Urology, Ghent University Hospital, Ghent, Belgium Financial interest and/or other relationship with Astellas, Allergan, Bard, Medtronic and Ferring. Equal study contribution. More articles by this author Annick Viaene Department of Physical Medicine and Orthopedic Surgery, Ghent University Hospital, Ghent, Belgium Equal study contribution. More articles by this author An-Sofie Goessaert Department of Urology, Ghent University Hospital, Ghent, Belgium More articles by this author Friedl Van Haverbeke Department of Urology, AZ Nikolaas, Sint-Niklaas, Belgium More articles by this author Piet Hoebeke Department of Urology, Ghent University Hospital, Ghent, Belgium More articles by this author Ann Raes Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium More articles by this author Karel Everaert Department of Urology, Ghent University Hospital, Ghent, Belgium More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2515697861 title "Circadian Rhythms in Water and Solute Handling in Adults with a Spinal Cord Injury" @default.
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