Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: Zeitschrift für Gerontologie und Geriatrie 3/2019

14.03.2018 | Original Contributions

Do independent geriatric outpatients with nocturnal polyuria profit from desmopressin?

verfasst von: Dr. W. Weinrebe, S. Käbe-Frisch, I. Füsgen, M. Karaman, E. Johannsdottir, S. Rupp

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 3/2019

Einloggen, um Zugang zu erhalten

Abstract

Objective

To compare the efficacy of desmopressin and placebo in independent geriatric outpatients with nocturnal polyuria (NP).

Methods

A prospective, randomized, single-center, national, double blind, placebo-controlled, fixed-dose, parallel group comparative trial was carried out. The study included 110 geriatric outpatients, 55 patients per treatment group using desmopressin acetate nasal spray (strength: 0.1 mg/ml) once daily of 10 μg/spray blast or placebo.

Measurement

The NP positive geriatric outpatients with >33% nocturnal urine output volume, antidiuretic hormone (ADH) positive or negative were treated over 10 days with intranasal spray in the evening time (7 p.m.), drug or placebo. On day 1 voiding frequency, voiding volumes day and night, serum osmolarity and arginine-vasopressin (AVP) were measured at 7 p.m. On days 2, 5 and 10 creatinine, blood urea nitrogen (bun), blood count and C‑reactive protein (CrP), vena cava diameter and bioimpedance were measured and a structured interview was implemented (voiding frequency, sleeping behavior and subjective and cognitive behavior).

Results

The NP patients showed a mean night voiding volume of 50.60%, 39.21% (n = 102) showed a low AVP level at baseline with no correlation to sodium concentration or voiding frequencies. The primary efficacy criterion, a decrease of the nocturnal voiding frequency during the course of the clinical trial as change from baseline at day 10 (visit 4) was 50% versus 41.40% in the verum versus placebo group, respectively but the differences were not significant. The U‑test showed superiority of AVP-positive NP patients to a positive reaction on desmopressin. Sleeping time hours increased in both groups without significant differences.

Conclusion

In this 10-day clinical trial desmopressin was not proven to be therapeutically superior to placebo with respect to micturition frequency or sleeping hours. Independent geriatric outpatients with decreased ADH levels seemed to respond and benefit from active treatment with desmopressin. The unexpected results in the placebo group may be due to the effect of intensive outpatient care and information on NP outpatients with normal AVP levels.

Sie möchten Zugang zu diesem Inhalt erhalten? Dann informieren Sie sich jetzt über unsere Produkte:

Zeitschrift für Gerontologie und Geriatrie

Print-Titel

• Themenbezogene Hefte behandeln Fragen der Gerontologie, der Biologie und Grundlagenforschung des Alterns und der geriatrischen Forschung

• Erweitert mit Beiträgen zu Therapie, Psychologie und Soziologie sowie der praktischen Altenpflege.  

• Hot topics von Experten knapp, aussagekräftig und provokativ kommentiert

Literatur
1.
Zurück zum Zitat Sommer P, Nielsen KK, Bauer T (1990) Voiding patterns in men evaluated by a questionaire survey. Br J Urol 65:155–160 CrossRefPubMed Sommer P, Nielsen KK, Bauer T (1990) Voiding patterns in men evaluated by a questionaire survey. Br J Urol 65:155–160 CrossRefPubMed
2.
Zurück zum Zitat Sommer P, Nielsen KK, Bauer T (1990) Voiding patterns in women evaluated by a questionaire survey. Br J Urol 66:12–15 CrossRefPubMed Sommer P, Nielsen KK, Bauer T (1990) Voiding patterns in women evaluated by a questionaire survey. Br J Urol 66:12–15 CrossRefPubMed
3.
Zurück zum Zitat Van Kerrebroeck P, Abrams P, Chaikin D (2002) The standardisation of terminology in nocturia: report from the standardization sub-committee of the International Continence Society. Neurourol Urodyn 21:179–183 CrossRef Van Kerrebroeck P, Abrams P, Chaikin D (2002) The standardisation of terminology in nocturia: report from the standardization sub-committee of the International Continence Society. Neurourol Urodyn 21:179–183 CrossRef
4.
Zurück zum Zitat Bliwise DL, Foley DJ, Vitiello MV, Ansari FP, Ancoli-Israel S, Walsh JK (2008) Nocturia and disturbed sleep in the elderly. Sleep Med 10:540–548 CrossRefPubMedPubMedCentral Bliwise DL, Foley DJ, Vitiello MV, Ansari FP, Ancoli-Israel S, Walsh JK (2008) Nocturia and disturbed sleep in the elderly. Sleep Med 10:540–548 CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Temml C, Ponholzer A, Gutjahr G, Berger I, Marszalek M, Madersbacher S (2009) Nocturia is an age-independent risk factor for hip-fractures in men. Neurourol Urodyn 28(8):949–952 CrossRef Temml C, Ponholzer A, Gutjahr G, Berger I, Marszalek M, Madersbacher S (2009) Nocturia is an age-independent risk factor for hip-fractures in men. Neurourol Urodyn 28(8):949–952 CrossRef
6.
Zurück zum Zitat Booth J, McMillan L (2009) The impact of nocturia on older people—implications for nursing practice. Br J Nursing 18(10):592–596 CrossRef Booth J, McMillan L (2009) The impact of nocturia on older people—implications for nursing practice. Br J Nursing 18(10):592–596 CrossRef
7.
Zurück zum Zitat Vaughan CP, Brown CJ, Goode PS, Burgio KL, Allman RM, Johnson TM 2nd (2010) The association of nocturia with incident falls in an elderly community-dwelling cohort. Int J Clin Pract 64(5):577–583 CrossRefPubMedPubMedCentral Vaughan CP, Brown CJ, Goode PS, Burgio KL, Allman RM, Johnson TM 2nd (2010) The association of nocturia with incident falls in an elderly community-dwelling cohort. Int J Clin Pract 64(5):577–583 CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Parsons JK, Mougey J, Lambert L, Wilt TJ, Fink HA, Garzotto M, Barrett-Connor E, Marshall LM (2009) Lower urinary tract symptoms increase the risk of falls in older men. BJU Int 104(1):63–68 CrossRefPubMedPubMedCentral Parsons JK, Mougey J, Lambert L, Wilt TJ, Fink HA, Garzotto M, Barrett-Connor E, Marshall LM (2009) Lower urinary tract symptoms increase the risk of falls in older men. BJU Int 104(1):63–68 CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Scandi Primus G, Madersbacher H, Elnekheli M, Hanzal E, Heidler H, Böhmer F, Mahn W, Struhal G, Klingler C (2006) Differentialdiagnose und Therapie der Nykturie – Konsensusstatement. J Urol Urogynäkol 13(1):21–27 Scandi Primus G, Madersbacher H, Elnekheli M, Hanzal E, Heidler H, Böhmer F, Mahn W, Struhal G, Klingler C (2006) Differentialdiagnose und Therapie der Nykturie – Konsensusstatement. J Urol Urogynäkol 13(1):21–27
10.
Zurück zum Zitat Füsgen I, Weinrebe W (2000) Nocturnal polyuria syndrome. Eur J Geriatr 2(1):30–34 Füsgen I, Weinrebe W (2000) Nocturnal polyuria syndrome. Eur J Geriatr 2(1):30–34
11.
Zurück zum Zitat Kujubu DA, Aboseif SR (2008) An overview of nocturia and the syndrome of nocturnal polyuria in the elderly. Nat Clin Pract Nephrol 4(8):426–435 CrossRefPubMed Kujubu DA, Aboseif SR (2008) An overview of nocturia and the syndrome of nocturnal polyuria in the elderly. Nat Clin Pract Nephrol 4(8):426–435 CrossRefPubMed
12.
Zurück zum Zitat Asplund R (1999) Mortality in the elderly in the relation to nocturnal micturition. BJU Int 84:297–301 CrossRefPubMed Asplund R (1999) Mortality in the elderly in the relation to nocturnal micturition. BJU Int 84:297–301 CrossRefPubMed
13.
Zurück zum Zitat Irwin DF, Abrams P, Milsom I, Kopp Z, Reilly K (2008) Understanding the elements of overactive bladder: questions raised by the EPIC study. BJU Int 101:1381–1387 CrossRefPubMed Irwin DF, Abrams P, Milsom I, Kopp Z, Reilly K (2008) Understanding the elements of overactive bladder: questions raised by the EPIC study. BJU Int 101:1381–1387 CrossRefPubMed
14.
Zurück zum Zitat Hernandez FC, Ristol PJ, Estivil E, Miranda Batista JE, Lopez Aramburu MA (2007) Importance of nocturia and its impact on quality of life in patient with benign prostratic hyperplasia. Actas Urol Esp 31:2623–2629 Hernandez FC, Ristol PJ, Estivil E, Miranda Batista JE, Lopez Aramburu MA (2007) Importance of nocturia and its impact on quality of life in patient with benign prostratic hyperplasia. Actas Urol Esp 31:2623–2629
15.
Zurück zum Zitat Yoshimura K, Obara H, Ichioka K (2003) Nocturia and benign prostatic hyperplasia. Urology 61:786–790 CrossRefPubMed Yoshimura K, Obara H, Ichioka K (2003) Nocturia and benign prostatic hyperplasia. Urology 61:786–790 CrossRefPubMed
16.
Zurück zum Zitat Asplund R (2005) Nocturia in relation to sleep, health, and medical treatment in the elderly. BJU Int 96(Suppl 1):15–21 CrossRefPubMed Asplund R (2005) Nocturia in relation to sleep, health, and medical treatment in the elderly. BJU Int 96(Suppl 1):15–21 CrossRefPubMed
17.
Zurück zum Zitat Asplund R (2004) Nocturia, nocturnal polyuria, and sleep quality in the elderly. J Psychosom Res 56(5):517–525 CrossRefPubMed Asplund R (2004) Nocturia, nocturnal polyuria, and sleep quality in the elderly. J Psychosom Res 56(5):517–525 CrossRefPubMed
18.
Zurück zum Zitat Boongird S, Shah N, Nolin TD, Unruh ML (2010) Nocturia and aging: diagnosis and treatment. Adv Chronic Kidney Dis 17(4):e27–e40 CrossRefPubMed Boongird S, Shah N, Nolin TD, Unruh ML (2010) Nocturia and aging: diagnosis and treatment. Adv Chronic Kidney Dis 17(4):e27–e40 CrossRefPubMed
19.
Zurück zum Zitat Moon DG, Jin MH, Lee JG, Kim JJ, Kim MG, Cha DR (2004) Antidiuretic hormone in elderly male patients with severe nocturia: a circadian study. BJU Int 94(4):571–575 CrossRefPubMed Moon DG, Jin MH, Lee JG, Kim JJ, Kim MG, Cha DR (2004) Antidiuretic hormone in elderly male patients with severe nocturia: a circadian study. BJU Int 94(4):571–575 CrossRefPubMed
20.
Zurück zum Zitat Mattiason A, Abrams P, Van Kerrebroeck P, Walter S (2002) Efficacy of desmopressin in the treatment of nocturia, a double-blind placebo controlled study in men. BJU Int 89:855–862 CrossRef Mattiason A, Abrams P, Van Kerrebroeck P, Walter S (2002) Efficacy of desmopressin in the treatment of nocturia, a double-blind placebo controlled study in men. BJU Int 89:855–862 CrossRef
21.
Zurück zum Zitat Asplund R (2008) Nocturia in relation to sleep, health, and medical treatment in the elderly. BJU Int 95(Supplement 1):15–21 Asplund R (2008) Nocturia in relation to sleep, health, and medical treatment in the elderly. BJU Int 95(Supplement 1):15–21
22.
Zurück zum Zitat Van Kerrebroeck P, Hashim H, Holm-Larsen T, Robinson D, Stanley N (2010) Thinking beyond the bladder: antidiuretic treatment of nocturia. Int J Clin Pract 64(6):807–816 CrossRefPubMed Van Kerrebroeck P, Hashim H, Holm-Larsen T, Robinson D, Stanley N (2010) Thinking beyond the bladder: antidiuretic treatment of nocturia. Int J Clin Pract 64(6):807–816 CrossRefPubMed
23.
Zurück zum Zitat Van Kerrebroeck P, Rezapour M, Cortesse A, Thüroff J, Riis A, Nørgaard JP (2007) Desmopressin in the treatment of nocturia: a double-blind, placebo-controlled study. Eur Urol 52(1):221–229 CrossRefPubMed Van Kerrebroeck P, Rezapour M, Cortesse A, Thüroff J, Riis A, Nørgaard JP (2007) Desmopressin in the treatment of nocturia: a double-blind, placebo-controlled study. Eur Urol 52(1):221–229 CrossRefPubMed
24.
Zurück zum Zitat Asplund R, Sundberg B, Bengtsson P (1999) Oral desmopressin for nocturnal polyuria in elderly subjects: a double-blind, placebo-controlled randomized exploratory study. BJU Int 83(6):591–595 (Apr) CrossRefPubMed Asplund R, Sundberg B, Bengtsson P (1999) Oral desmopressin for nocturnal polyuria in elderly subjects: a double-blind, placebo-controlled randomized exploratory study. BJU Int 83(6):591–595 (Apr) CrossRefPubMed
Metadaten
Titel
Do independent geriatric outpatients with nocturnal polyuria profit from desmopressin?
verfasst von
Dr. W. Weinrebe
S. Käbe-Frisch
I. Füsgen
M. Karaman
E. Johannsdottir
S. Rupp
Publikationsdatum
14.03.2018
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 3/2019
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-018-1379-7