Document Detail

Fluid control in elderly patients with nocturia.
MedLine Citation:
PMID:  19207113     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To investigate the pathophysiology of nocturnal polyuria associated with aging. METHODS: Fifty patients (mean age 67.7 years, range 50-87) with nocturia were recruited for this prospective study. Patients were classified into nocturnal polyuria (NP) and non-nocturnal polyuria (non-NP) groups based on records of their frequency-volume charts. A hypertonic saline infusion test was carried out to evaluate individual osmotic and volume control. RESULTS: In the NP group, there was a significantly increased nocturnal diuretic rate compared with the daytime diuretic rate. In the non-NP group, there was a significantly decreased nocturnal diuretic rate compared with the daytime rate. There was also a positive correlation between systolic blood pressure and nocturnal diuretic rate, and a negative correlation between systolic blood pressure and daytime diuretic rate in those with NP, but no correlation in those without NP. Thus, a close relationship between diuretic rates and systolic blood pressure was seen in NP patients. Moreover, a slight overall shift upward from the physiological range of plasma osmolality relative to arginine vasopressin after hypertonic saline loading was seen in those with NP compared with those without. An altered circadian rhythm was also seen in diurnal plasma arginine vasopressin levels in patients with and without NP. CONCLUSIONS: Patients with nocturnal polyuria are likely to have a more hypervolemic or vasoconstrictive condition. It is considered that non-osmotic control takes on a greater meaning in patients with nocturnal polyuria, though osmotic control contributes less to diuresis within the physiological plasma osmolality range with aging.
Osamu Natsume; Yoshiteru Kaneko; Akihide Hirayama; Kiyohide Fujimoto; Yoshihiko Hirao
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-02-04
Journal Detail:
Title:  International journal of urology : official journal of the Japanese Urological Association     Volume:  16     ISSN:  1442-2042     ISO Abbreviation:  Int. J. Urol.     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-20     Completed Date:  2009-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440237     Medline TA:  Int J Urol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  307-13     Citation Subset:  IM    
Department of Urology, Uda City Hospital, Uda, Nara, Japan.
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MeSH Terms
Age Factors
Aged, 80 and over
Arginine Vasopressin / blood*
Case-Control Studies
Circadian Rhythm
Hematuria / diagnosis,  urine
Middle Aged
Multivariate Analysis
Nocturia / diagnosis*,  epidemiology
Osmolar Concentration
Polyuria / physiopathology*
Prospective Studies
Regression Analysis
Risk Assessment
Saline Solution, Hypertonic / diagnostic use*
Severity of Illness Index
Sex Factors
Water-Electrolyte Balance / physiology
Reg. No./Substance:
0/Saline Solution, Hypertonic; 113-79-1/Arginine Vasopressin

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

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