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Clinical characteristics, nocturnal antidiuretic hormone levels, and responsiveness to DDAVP of school children with primary nocturnal enuresis

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Abstract

Purpose

Decreased nocturnal antidiuretic hormone (ADH) excretion has been suggested to be a causative factor for PNE in children. We investigate the demographic characteristics and nocturnal ADH levels of children with PNE who attended a tertiary referral center and to determine their response to treatment with desamino-d-arginine vasopressin (DDAVP).

Methods

We performed a retrospective study in 90 PNE children aged 6–12 years. We recorded the gender, height, weight, number of children per family, and psychosocial problems and compared these findings with the corresponding data obtained from a national survey. We also measured the nocturnal ADH levels and evaluated the response rate to DDAVP.

Results

The number of PNE patients decreased with an increase in age. Enuresis was significantly associated with male gender (P = 0.044) and more number of children per family (P = 0.043). The rates of comorbidity with defecation problems, obesity, attention-deficit hyperactivity disorder (ADHD), and overweight were 36.7, 17.8, 12.2, and 10%, respectively. Although the prevalence of obesity and ADHD was higher among children with PNE, there was no significant difference between PNE patients and their prevalence in the community. The ADH levels at 2 a.m. and 8 a.m. were 0.87 ± 0.75 and 0.89 ± 0.76 pg/ml, respectively. In the 50 (55.5%) patients who received DDAVP treatment, the complete- and partial response rates were 86 and 14%, respectively.

Conclusions

Our data confirmed that PNE was predominant in boys and larger family, and similar to the findings for disease prevalence, the number of children seeking treatment tended to decrease with increasing age. Low ADH levels were recognized as a possible cause of PNE, thereby explaining the good response to DDAVP treatment in Taiwanese children with PNE.

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References

  1. Chang P, Chen WJ, Tsai WY, Chiu YN (2001) An epidemiological study of nocturnal enuresis in Taiwanese children. BJU Int 87:678–681

    Article  PubMed  CAS  Google Scholar 

  2. Lee SD, Sohn DW, Lee JZ, Park NC, Chung MK (2000) An epidemiological study of enuresis in Korean children. BJU Int 85:869–873

    Article  PubMed  CAS  Google Scholar 

  3. Bower WF, Moore KH, Shepherd RB, Adams RD (1996) The epidemiology of childhood enuresis in Australia. Br J Urol 78:602–606

    Article  PubMed  CAS  Google Scholar 

  4. Kalo BB, Bella H (1996) Enuresis: prevalence and associated factors among primary school children in Saudi Arabia. Acta Paediatr 85:1217–1222

    Article  PubMed  CAS  Google Scholar 

  5. Wille S, Aili M, Harris A, Aronson S (1994) Plasma and urinary levels of vasopressin in enuretic and non-enuretic children. Scand J Urol Nephrol 28:119–122

    Article  PubMed  CAS  Google Scholar 

  6. Aikawa T, Kasahara T, Uchiyama M (1998) The arginine-vasopressin secretion profile of children with primary nocturnal enuresis. Eur Urol 33:41–54

    Article  PubMed  CAS  Google Scholar 

  7. Rittig S, Knudsen UB, Norgaard JP, Pedersen EB, Djurhuus JC (1989) Abnormal diurnal rhythm of plasma vasopressin and urinary output in patients with enuresis. Am J Physiol 21:442–447

    Google Scholar 

  8. Devitt H, Holland P, Butler R, Redfern E, Hiley E, Roberts G (1999) Plasma vasopressin and response to treatment in primary nocturnal enuresis. Arch Dis Child 80(5):448–451

    Article  PubMed  CAS  Google Scholar 

  9. Chiozza ML, Plebani M, Scaccianoce C, Biraghi M, Zacchello G (1998) Evaluation of antidiuretic hormone before and after long-term treatment with desmopressin in a group of enuretic children. Br J Urol 81(Suppl 3):53–55

    PubMed  CAS  Google Scholar 

  10. Balat A, Cekmen M, Yürekli M, Gül AK, Ozbek E, Korkut M, Tarakçioglu M, Sahinöz S, Anarat A (2002) Adrenomedullin and nitrite levels in children with primary nocturnal enuresis. Pediatr Nephrol 17(8):620–624

    Article  PubMed  Google Scholar 

  11. Tomasi PA, Siracusano S, Monni AM, Mela G, Delitala G (2001) Decreased nocturnal urinary antidiuretic hormone excretion in enuresis is increased by imipramine. BJU Int 88(9):932–937

    Article  PubMed  CAS  Google Scholar 

  12. Semolic N, Ravnikar A, Meglic A, Japelj-Pavesić B, Kenda RB (2009) The occurrence of primary nocturnal enuresis and associated factors in 5-year-old outpatients in Slovenia. Acta Paediatr 98(12):1994–1998

    Article  PubMed  CAS  Google Scholar 

  13. Baeyens D, Roeyers H, Demeyere I, Verté S, Hoebeke P, Vande Walle J (2005) Attention-deficit/hyperactivity disorder (ADHD) as a risk factor for persistent nocturnal enuresis in children: a two-year follow-up study. Acta Paediatr 94(11):1619–1625

    Article  PubMed  Google Scholar 

  14. Barone JG, Hanson C, DaJusta DG, Gioia K, England SJ, Schneider D (2009) Nocturnal enuresis and overweight are associated with obstructive sleep apnea. Pediatrics 124(1):e53–e59

    Article  PubMed  Google Scholar 

  15. Wu TC, Chen LK, Pan WH, Tang RB, Hwang SJ, Wu L, Eugene James F, Chen PH (2011) Constipation in Taiwan elementary school students: a nationwide survey. J Chin Med Assoc 74(2):57–61

    Article  PubMed  Google Scholar 

  16. Tzang RF, Wu KH, Liou CP (2002) Prevalence of attention deficit/hyperactivity disorder in a Taiwan elementary school Taiwanese. J Psychiatry 16:202–210

    Google Scholar 

  17. Rawashdeh YF, Hvistendahl GM, Kamperis K, Hansen MN, Djurhuus JC (2002) Demographics of enuresis patients attending a referral centre. Scand J Urol Nephrol 36(5):348–353

    Article  PubMed  Google Scholar 

  18. Tai HL, Chang YJ, Chang SC, Chen GD, Chang CP, Chou MC (2007) The epidemiology and factors associated with nocturnal enuresis and its severity in primary school children in Taiwan. Acta Paediatr 96(2):242–245

    Article  PubMed  Google Scholar 

  19. Wen JG, Wang QW, Chen Y, Wen JJ, Liu K (2006) An epidemiological study of primary nocturnal enuresis in Chinese children and adolescents. Eur Urol 49(6):1107–1113

    Article  PubMed  Google Scholar 

  20. Cayan S, Doruk E, Bozlu M, Nass Duce M, Ulusoy E, Akbay E (2001) The assessment of constipation in monosymptomatic primary nocturnal enuresis. Int Urol Nephrol 33:513–516

    Article  PubMed  CAS  Google Scholar 

  21. Robson LM, Leung AK, Van Howe R (2005) Primary and secondary nocturnal enuresis: similarities in presentation. Pediatrics 115:956–959

    Article  PubMed  Google Scholar 

  22. McGrath KH, Caldwell PH, Jones MP (2008) The frequency of constipation in children with nocturnal enuresis: a comparison with parental reporting. J Paediatr Child Health 44(1–2):19–27

    PubMed  Google Scholar 

  23. Baeyens D, Roeyers H, Vande Walle J, Hoebeke P (2005) Behavioural problems and attention-deficit hyperactivity disorder in children with enuresis: a literature review. Eur J Pediatr 164(11):665–672

    Article  PubMed  Google Scholar 

  24. Zink S, Freitag CM, von Gontard A (2008) Behavioral comorbidity differs in subtypes of enuresis and urinary incontinence. J Urol 179(1):295–298

    Article  PubMed  Google Scholar 

  25. Ghanizadeh A, Mohammadi MR, Moini R (2008) Comorbidity of psychiatric disorders and parental psychiatric disorders in a sample of Iranian children with ADHD. Atten Disord 12(2):149–155

    Article  Google Scholar 

  26. Baeyens D, Roeyers H, Van Erdeghem S, Hoebeke P, Vande Walle J (2007) The prevalence of attention deficit-hyperactivity disorder in children with nonmonosymptomatic nocturnal enuresis: a 4-year follow up study. J Urol 178(6):2616–2620

    Article  PubMed  Google Scholar 

  27. Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA (2006) The worldwide prevalence of ADHD: a systematic review and meta regression analysis. J Sleep Res 15(4):403–414

    Article  Google Scholar 

  28. Kamperis K, Rittig S, Jørgensen KA, Djurhuus JC (2006) Nocturnal polyuria in monosymptomatic nocturnal enuresis refractory to desmopressin treatment. Am J Physiol Renal Physiol 291(6):F1232–F1240

    Article  PubMed  CAS  Google Scholar 

  29. Valenti G, Laera A, Pace G, Aceto G, Lospalluti ML, Penza R, Selvaggi FP, Chiozza ML, Svelto M (2000) Urinary aquaporine 2 and calciuria correlate with severity of enuresis in children. J Am Soc Nephrol 11(10):1873–1881

    PubMed  CAS  Google Scholar 

  30. Miller M, Moses AM (1972) Urinary antidiuretic hormone in polyuric disorders and in inappropriate ADH syndrome. Ann Intern Med 77(5):715–721

    PubMed  CAS  Google Scholar 

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Acknowledgments

The authors acknowledge support from the Taipei Veterans General Hospital (VGH100A-012).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan

    Jei-Wen Chang & Ling-Yu Yang

  2. Division of Pediatric Surgery, Department of Surgery, Taipei Veterans General Hospital, No 201, Section 2, Shih-Pai Rd, Taipei, 11217, Taiwan

    Tai-Wai Chin & Hsin-Lin Tsai

  3. Institute of Clinical Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan

    Jei-Wen Chang, Ling-Yu Yang, Tai-Wai Chin & Hsin-Lin Tsai

Authors
  1. Jei-Wen Chang
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  2. Ling-Yu Yang
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Correspondence to Hsin-Lin Tsai.

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Chang, JW., Yang, LY., Chin, TW. et al. Clinical characteristics, nocturnal antidiuretic hormone levels, and responsiveness to DDAVP of school children with primary nocturnal enuresis. World J Urol 30, 567–571 (2012). https://doi.org/10.1007/s00345-011-0753-5

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  • DOI: https://doi.org/10.1007/s00345-011-0753-5

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