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Future Considerations in Nocturia and Nocturnal Polyuria.

Authors
  • Weiss, Jeffrey P1
  • Monaghan, Thomas F2
  • Epstein, Matthew R2
  • Lazar, Jason M3
  • 1 Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY. Electronic address: [email protected]
  • 2 Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY.
  • 3 Department of Medicine, Division of Cardiovascular Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY.
Type
Published Article
Journal
Urology
Publication Date
Nov 01, 2019
Volume
133S
Pages
34–42
Identifiers
DOI: 10.1016/j.urology.2019.06.014
PMID: 31233816
Source
Medline
Language
English
License
Unknown

Abstract

Nocturnal polyuria (NP), the most common etiology of nocturia, can be caused by various medical conditions, including cardiovascular disease, obstructive sleep apnea, renal tubular dysfunction, as well as medications (eg, diuretics) and/or behavioral patterns. NP in the absence of underlying medical conditions has been described as NP syndrome and is thought be the result of impaired circadian release of endogenous arginine vasopressin. Desmopressin, a synthetic arginine vasopressin analog, has been shown to be an effective replacement therapy in adults with nocturia due to NP. Further studies on the subset of patients with NP syndrome are warranted to maximize benefit from antidiuretic treatment. In addition, a connection between the pathophysiological mechanisms underlying NP and essential hypertension has been suggested, and hypertension has been shown to be a significant risk factor for nocturia, while an association between NP and brain natriuretic peptide levels has also been reported in patients with nocturia. Hypertension is now viewed as a disorder of blood vessels and treatment is directed at the vasculature rather than the blood pressure, with the latter currently serving as a biomarker for arterial injury. Nocturia is thought to be associated with the beginning of this cardiovascular continuum as studies have reported a link between coronary heart disease and nocturia. Therefore, there is an increasing need to elucidate the complex mechanisms implicated in the association between nocturia and hypertension to promote the development of more individualized therapies for the treatment of nocturia. Copyright © 2019. Published by Elsevier Inc.

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