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BMJ (Clinical Research Ed.) Feb 2019
Topics: Antidiuretic Agents; Deamino Arginine Vasopressin; Diabetes Insipidus; Endocrinology; Humans; Male; Osmolar Concentration; Polydipsia; Polyuria; United Kingdom; Young Adult
PubMed: 30819684
DOI: 10.1136/bmj.l321 -
American Journal of Kidney Diseases :... Apr 2022
Topics: Humans; Hypercalcemia; Kidney; Polyuria
PubMed: 35331383
DOI: 10.1053/j.ajkd.2021.09.030 -
Advances in Experimental Medicine and... 2017Several aquaporin (AQP )-type water channels are expressed in kidney: AQP1 in the proximal tubule, thin descending limb of Henle, and vasa recta; AQP2 -6 in the... (Review)
Review
Several aquaporin (AQP )-type water channels are expressed in kidney: AQP1 in the proximal tubule, thin descending limb of Henle, and vasa recta; AQP2 -6 in the collecting duct; AQP7 in the proximal tubule; AQP8 in the proximal tubule and collecting duct; and AQP11 in the endoplasmic reticulum of proximal tubule cells. AQP2 is the vasopressin-regulated water channel that is important in hereditary and acquired diseases affecting urine-concentrating ability. The roles of AQPs in renal physiology and transepithelial water transport have been determined using AQP knockout mouse models. This chapter describes renal physiologic insights revealed by phenotypic analysis of AQP knockout mice and the prospects for further basic and clinical studies.
Topics: Animals; Aquaporin 1; Biological Transport; Gene Expression Regulation; Humans; Kidney; Kidney Concentrating Ability; Mice; Mice, Knockout; Osmolar Concentration; Polyuria; Protein Isoforms; Urea; Water; Water-Electrolyte Balance
PubMed: 28258571
DOI: 10.1007/978-94-024-1057-0_9 -
NeoReviews Oct 2023
Topics: Infant, Newborn; Humans; Polyuria; Hydrocephalus
PubMed: 37777618
DOI: 10.1542/neo.24-10-e658 -
Best Practice & Research. Clinical... Sep 2020In the pregnant patient, hypotonic polyuria in the setting of elevated serum osmolality and polydipsia should narrow the differential to causes related to diabetes... (Review)
Review
In the pregnant patient, hypotonic polyuria in the setting of elevated serum osmolality and polydipsia should narrow the differential to causes related to diabetes insipidus (DI). Gestational DI, also called transient DI of pregnancy, is a distinct entity, unique from central DI or nephrogenic DI which may both become exacerbated during pregnancy. These three different processes relate to vasopressin, where increased metabolism, decreased production or altered renal sensitivity to this neuropeptide should be considered. Gestational DI involves progressively rising levels of placental vasopressinase throughout pregnancy, resulting in decreased endogenous vasopressin and resulting hypotonic polyuria worsening through the pregnancy. Gestational DI should be distinguished from central and nephrogenic DI that may be seen during pregnancy through use of clinical history, urine and serum osmolality measurements, response to desmopressin and potentially, the newer, emerging copeptin measurement. This review focuses on a brief overview of osmoregulatory and vasopressin physiology in pregnancy and how this relates to the clinical presentation, pathophysiology, diagnosis and management of gestational DI, with comparisons to the other forms of DI during pregnancy. Differentiating the subtypes of DI during pregnancy is critical in order to provide optimal management of DI in pregnancy and avoid dehydration and hypernatremia in this vulnerable population.
Topics: Dehydration; Diabetes Insipidus; Diabetes Insipidus, Nephrogenic; Diabetes Insipidus, Neurogenic; Diagnosis, Differential; Female; Humans; Hypernatremia; Neurophysins; Osmoregulation; Polydipsia; Polyuria; Pregnancy; Pregnancy Complications; Protein Precursors; Vasopressins; Water-Electrolyte Balance
PubMed: 32205050
DOI: 10.1016/j.beem.2020.101384 -
American Journal of Kidney Diseases :... Nov 2018
Topics: Anemia, Aplastic; Bacteremia; Blood Chemical Analysis; Follow-Up Studies; Hematopoietic Stem Cell Transplantation; Humans; Klebsiella Infections; Male; Middle Aged; Mycoses; Polyuria; Postoperative Complications; Recurrence; Sinusitis; Treatment Outcome
PubMed: 30343734
DOI: 10.1053/j.ajkd.2018.07.006 -
International Journal of Urology :... Mar 2017Enuresis was historically viewed as a primarily psychiatric disorder, but this understanding has changed dramatically since the end of the last century, when it became... (Review)
Review
Enuresis was historically viewed as a primarily psychiatric disorder, but this understanding has changed dramatically since the end of the last century, when it became clear that somatic factors, such as nocturnal polyuria as a result of vasopressin deficiency, nocturnal detrusor overactivity and high arousal thresholds, all play a crucial role in enuresis pathogenesis. It has also become clear that enuresis is inherited in the majority of cases, although the correlation between genotype and enuretic phenotype is not straightforward. The standard view of enuresis as being the result of either (i) nocturnal polyuria and high arousal thresholds; or (ii) nocturnal detrusor overactivity and high arousal thresholds has become well-established, but further research now complicates the picture. First, psychological/psychiatric problems are overrepresented in enuresis, and might in a minority of cases have a causal or aggravating role. Second, nocturnal polyuria is not always linked to vasopressin deficiency. Third, nocturnal detrusor overactivity is in itself pathogenetically heterogeneous, and could be linked to constipation. Fourth, the sleep of enuretic children might be "deep," but possibly also disturbed (by obstructed airways or a distended or contracting bladder). These children might have high arousal thresholds because of the enuresis instead of the other way around. The same might possibly be said about nocturnal polyuria. Taking these new insights into account, a new model of enuresis pathogenesis is presented, which is more complicated but hopefully also more true than the standard consensus.
Topics: Adult; Antidiuretic Agents; Arousal; Central Nervous System; Child; Constipation; Deamino Arginine Vasopressin; Enuresis; Humans; Polyuria; Sleep; Urinary Bladder, Overactive; Vasopressins
PubMed: 28208214
DOI: 10.1111/iju.13310 -
International Urology and Nephrology Jan 2023Nocturia is the complaint that an individual has to wake up at night one or more times to urinate. It is a frequent condition among older adults and entails detrimental... (Review)
Review
Nocturia is the complaint that an individual has to wake up at night one or more times to urinate. It is a frequent condition among older adults and entails detrimental effects with regard to sleeping, sexual activity, comfort, depression, mental function and vitality. It is clinically important to distinguish it from global polyuria, defined as a urinary rate ≥ 125 ml/h (3000 ml/day), as well as from nocturnal polyuria, which is an abnormally large volume of urine during sleep associated with a decreased daytime urine production. A Frequency Volume Chart (FVC), overnight water deprivation test with renal concentrating capacity test, and the nocturnal bladder capacity index are some of the methods that help establish the underlying pathology of this condition and hence define an adequate treatment plan.
Topics: Humans; Aged; Nocturia; Polyuria; Urinary Bladder; Sleep; Algorithms
PubMed: 35945304
DOI: 10.1007/s11255-022-03317-y -
International Journal of Clinical... Nov 2017To raise awareness on nocturia disease burden and to provide simplified aetiologic evaluation and related treatment pathways. (Review)
Review
AIM
To raise awareness on nocturia disease burden and to provide simplified aetiologic evaluation and related treatment pathways.
METHODS
A multidisciplinary group of nocturia experts developed practical advice and recommendations based on the best available evidence supplemented by their own experiences.
RESULTS
Nocturia is defined as the need to void ≥1 time during the sleeping period of the night. Clinically relevant nocturia (≥2 voids per night) affects 2%-18% of those aged 20-40 years, rising to 28%-62% for those aged 70-80 years. Consequences include the following: lowered quality of life; falls and fractures; reduced work productivity; depression; and increased mortality. Nocturia-related hip fractures alone cost approximately €1 billion in the EU and $1.5 billion in the USA in 2014. The pathophysiology of nocturia is multifactorial and typically related to polyuria (either global or nocturnal), reduced bladder capacity or increased fluid intake. Accurate assessment is predicated on frequency-volume charts combined with a detailed patient history, medicine review and physical examination. Optimal treatment should focus on the underlying cause(s), with lifestyle modifications (eg, reducing evening fluid intake) being the first intervention. For patients with sustained bother, medical therapies should be introduced; low-dose, gender-specific desmopressin has proven effective in nocturia due to idiopathic nocturnal polyuria. The timing of diuretics is an important consideration, and they should be taken mid-late afternoon, dependent on the specific serum half-life. Patients not responding to these basic treatments should be referred for specialist management.
CONCLUSIONS
The cause(s) of nocturia should be first evaluated in all patients. Afterwards, the underlying pathophysiology should be treated specifically, alone with lifestyle interventions or in combination with drugs or (prostate) surgery.
Topics: Antidiuretic Agents; Deamino Arginine Vasopressin; Humans; Life Style; Nocturia; Polyuria; Quality of Life
PubMed: 28984060
DOI: 10.1111/ijcp.13027 -
The Pan African Medical Journal 2018
Review
Topics: Adult; Erdheim-Chester Disease; Female; Humans; Immunologic Factors; Interferon-alpha; Polydipsia; Polyuria; Treatment Outcome
PubMed: 29875943
DOI: 10.11604/pamj.2018.29.62.4088