L Dossche1, J Vande Walle2, C Van Herzeele2. 1. Department of Paediatric Nephrology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. lien.dossche@ugent.be. 2. Department of Paediatric Nephrology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
Abstract
UNLABELLED: Nocturnal polyuria in monosymptomatic nocturnal enuresis (MNE) has so far mainly been attributed to a disturbed circadian rhythm of renal water handling. Low vasopressin levels overnight correlate with absent maximal concentrating activity, resulting in an increased nocturnal diuresis with low urinary osmolality. Therefore, treatment with desmopressin is a rational choice. Unfortunately, 20 to 60 % of children with monosymptomatic enuresis are desmopressin-resistant. There is increasing evidence that other disturbed circadian rhythms might play a role in nocturnal polyuria. This review focuses on renal aspects in the pathophysiology of nocturnal polyuria in MNE, with special emphasis on circadian rhythms. Articles related to renal circadian rhythms and enuresis were searched through the PubMed library with the goal of providing a concise review. CONCLUSION: Nocturnal polyuria can only partially be explained by blunted circadian rhythm of vasopressin secretion. Other alterations in the intrinsic renal circadian clock system also seem to be involved, especially in desmopressin-resistant enuresis. WHAT IS KNOWN: • Disturbance in the circadian rhythm of arginine vasopressin secretion is related to nocturnal polyuria in children with enuresis. • Desmopressin is recommended as a treatment for monosymptomatic nocturnal enuresis, working as a vasopressin analogue acting on V2 receptors in the collecting ducts of the kidney. What is New: • Other renal circadian rhythms might play a role in nocturnal polyuria, especially in desmopressin-resistant case.
UNLABELLED: Nocturnal polyuria in monosymptomatic nocturnal enuresis (MNE) has so far mainly been attributed to a disturbed circadian rhythm of renal water handling. Low vasopressin levels overnight correlate with absent maximal concentrating activity, resulting in an increased nocturnal diuresis with low urinary osmolality. Therefore, treatment with desmopressin is a rational choice. Unfortunately, 20 to 60 % of children with monosymptomatic enuresis are desmopressin-resistant. There is increasing evidence that other disturbed circadian rhythms might play a role in nocturnal polyuria. This review focuses on renal aspects in the pathophysiology of nocturnal polyuria in MNE, with special emphasis on circadian rhythms. Articles related to renal circadian rhythms and enuresis were searched through the PubMed library with the goal of providing a concise review. CONCLUSION:Nocturnal polyuria can only partially be explained by blunted circadian rhythm of vasopressin secretion. Other alterations in the intrinsic renal circadian clock system also seem to be involved, especially in desmopressin-resistant enuresis. WHAT IS KNOWN: • Disturbance in the circadian rhythm of arginine vasopressin secretion is related to nocturnal polyuria in children with enuresis. • Desmopressin is recommended as a treatment for monosymptomatic nocturnal enuresis, working as a vasopressin analogue acting on V2 receptors in the collecting ducts of the kidney. What is New: • Other renal circadian rhythms might play a role in nocturnal polyuria, especially in desmopressin-resistant case.
Authors: Pauline De Bruyne; Ann De Guchtenaere; Charlotte Van Herzeele; Ann Raes; Jo Dehoorne; Piet Hoebeke; Erik Van Laecke; Johan Vande Walle Journal: Eur J Pediatr Date: 2013-08-30 Impact factor: 3.183
Authors: J Krieger; L Laks; I Wilcox; R R Grunstein; L J Costas; J G McDougall; C E Sullivan Journal: Clin Sci (Lond) Date: 1989-10 Impact factor: 6.124
Authors: Johan G J Vande Walle; Guy A Bogaert; Sven Mattsson; Thierry Schurmans; Piet Hoebeke; Veerle Deboe; Jens Peter Norgaard Journal: BJU Int Date: 2006-03 Impact factor: 5.588
Authors: Kim Pauwaert; Sarah Dejonckheere; Elke Bruneel; Jolien Van Der Jeugt; Laura Keersmaekers; Saskia Roggeman; Ann De Guchtenaere; Johan Vande Walle; Karel Everaert Journal: Eur J Pediatr Date: 2019-09-05 Impact factor: 3.183
Authors: Marieke L van Engelenburg-van Lonkhuyzen; Esther M J Bols; Marc A Benninga; Wim A Verwijs; Rob A de Bie Journal: Eur J Pediatr Date: 2016-12-19 Impact factor: 3.183
Authors: José Murillo Bastos; Atila Victal Rondon; George Rafael Martins de Lima; Miguel Zerati; Edison Daniel Schneider-Monteiro; Carlos Augusto F Molina; Adriano de Almeida Calado; Ubirajara Barroso Journal: Int Braz J Urol Date: 2019 Sep-Oct Impact factor: 3.050