Document Detail


Effectiveness of oral desmopressin therapy in posterior urethral valve patients with polyuria and detection of factors affecting the therapy.
MedLine Citation:
PMID:  15998564     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The present study aims to evaluate the effect of desmopressin treatment on urine output, density and glomerular filtration rate (GFR) in patients with posterior urethral valve (PUV) and the factors affecting the response to this treatment. METHODS: A total of 68 PUV patients who were followed-up after valve ablation were examined with the fluid intake, urine output and GFR. Sixteen patients who were polyuric (a urine output more than 30 ml/kg/day) and had hypoosmolar urine (urinary density of 1015 or lower) included in the study. Blood chemistry and serum ADH level were studied. Following 5 days of observation, patients were given DDAVP perorally with a dosage of 0.4 mg/day, two equal doses per day. After 7 days and after a 3 month period of treatment, voiding characteristics, day-time and night-time urine densities and also GFR have been re-evaluated. RESULTS: The mean age was 6.8 years (range 2 to 11 years). The mean age at valve ablation was 20.7 months (range 5 months to 6 years). The mean daily urine output during first week and at the third month of the treatment had decreased significantly (p=0.004 and p=0.006). There was increase in night-time and day-time urine density in 10 patients (62%) and in 13 patients (81%) respectively at the third month evaluation. Increments in urine density were statistically significant for the third month evaluation. Nine (56%) patients had ADH levels within normal (<7 pcg/ml) levels and 7 patients had higher levels. There was no statistically significant difference between pretreatment and posttreatment micturation characteristics. However patients with voiding dysfunction responded better to DDAVP treatment. CONCLUSIONS: Desmopressin treatment improves polyuria in PUV patients. The responses are better particularly in PUV patients with significant bladder dysfunction. This supports the harmful role of polyuria on bladder dysfunction. The DDAVP treatment improves the day-time and night-time in PUV patients. Combination of DDAVP treatment with overnight catheterization may be a good alternative that needs to be evaluated by further prospective randomized studies.
Authors:
Sohrab Naghizadeh; Aykut Kefi; Hasan Serkan Dogan; Berk Burgu; Bulent Akdogan; Serdar Tekgul
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Publication Detail:
Type:  Journal Article     Date:  2005-06-22
Journal Detail:
Title:  European urology     Volume:  48     ISSN:  0302-2838     ISO Abbreviation:  Eur. Urol.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-18     Completed Date:  2006-02-10     Revised Date:  2006-03-14    
Medline Journal Info:
Nlm Unique ID:  7512719     Medline TA:  Eur Urol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  819-25     Citation Subset:  IM    
Affiliation:
Faculty of Medicine, Department of Urology, Hacettepe University, Sihhiye, 06100 Ankara, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Antidiuretic Agents / administration & dosage,  therapeutic use*
Child
Child, Preschool
Deamino Arginine Vasopressin / administration & dosage,  therapeutic use*
Follow-Up Studies
Glomerular Filtration Rate
Humans
Infant
Male
Polyuria / drug therapy*
Urination Disorders / drug therapy*
Urine / chemistry
Urodynamics
Vasopressins / blood
Chemical
Reg. No./Substance:
0/Antidiuretic Agents; 11000-17-2/Vasopressins; 16679-58-6/Deamino Arginine Vasopressin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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