An overview of nocturia and the syndrome of nocturnal polyuria in the elderly

Kujubu, Dean A.; Aboseif, Sherif R.

doi:10.1038/ncpneph0856

Cited by 47 publications

(29 citation statements)

References 87 publications

(43 reference statements)

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“…AVP, which is synthesized in specialized neurosecretory cells of the supraoptic and paraventricular nuclei of the hypothalamus, regulates body H 2 O and blood osmolarity through enhancing H 2 O reabsorption by the kidney's collecting ducts. In young diurnally active adults, the high-amplitude nocturnally peaking AVP circadian rhythm ensures most of the 24 h output of urine occurs during the daytime wake span (Donahue & Lowenthal, 1997;Kujubu & Aboseif, 2008;Singh et al, 1989). Beyond the age of~40-45 years, the amplitude of the AVP circadian rhythm progressively dampens toward zero, resulting in obliteration of its 24 h oscillation; as a consequence, the volume of urine production is no longer greatest during the diurnal activity span but during the nocturnal rest span, and typically exceeding the Figure 2.…”

Section: Nocturiamentioning

confidence: 96%

Circadian disruption: New clinical perspective of disease pathology and basis for chronotherapeutic intervention

Smolensky

Hermida

Reinberg

et al. 2016

Chronobiology International

151

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Biological processes are organized in time as innate rhythms defined by the period (τ), phase (peak [Φ] and trough time), amplitude (A, peak-trough difference) and mean level. The human time structure in its entirety is comprised of ultradian (τ < 20 h), circadian (20 h > τ < 28 h) and infradian (τ > 28 h) bioperiodicities. The circadian time structure (CTS) of human beings, which is more complicated than in lower animals, is orchestrated and staged by a brain central multioscillator system that includes a prominent pacemaker - the suprachiasmatic nuclei of the hypothalamus. Additional pacemaker activities are provided by the pineal hormone melatonin, which circulates during the nighttime, and the left and right cerebral cortices. Under ordinary circumstances this system coordinates the τ and Φ of rhythms driven by subservient peripheral cell, tissue and organ clock networks. Cyclic environmental, feeding and social time cues synchronize the endogenous 24 h clocks and rhythms. Accordingly, processes and functions of the internal environment are integrated in time for maximum biological efficiency, and they are also organized and synchronized in time to the external environment to ensure optimal performance and response to challenge. Artificial light at night (ALAN) exposure can alter the CTS as can night work, which, like rapid transmeridian displacement by air travel, necessitates realignment of the Φ of the multitude of 24 h rhythms. In 2001, Stevens and Rea coined the phrase "circadian disruption" (CD) to label the CTS misalignment induced by ALAN and shift work (SW) as a potential pathologic mechanism of the increased risk for cancer and other medical conditions. Current concerns relating to the effects of ALAN exposure on the CTS motivated us to renew our long-standing interest in the possible role of CD in the etiopathology of common human diseases and patient care. A surprisingly large number of medical conditions involve CD: adrenal insufficiency; nocturia; sleep-time non-dipping and rising blood pressure 24 h patterns (nocturnal hypertension); delayed sleep phase syndrome, non-24 h sleep/wake disorder; recurrent hypersomnia; SW intolerance; delirium; peptic ulcer disease; kidney failure; depression; mania; bipolar disorder; Parkinson's disease; Smith-Magenis syndrome; fatal familial insomnia syndrome; autism spectrum disorder; asthma; byssinosis; cancers; hand, foot and mouth disease; post-operative state; and ICU outcome. Poorly conceived medical interventions, for example nighttime dosing of synthetic corticosteroids and certain β-antagonists and cyclic nocturnal enteral or parenteral nutrition, plus lifestyle habits, including atypical eating times and chronic alcohol consumption, also can be causal of CD. Just as surprisingly are the many proven chronotherapeutic strategies available today to manage the CD of several of these medical conditions. In clinical medicine, CD seems to be a common, yet mostly unrecognized, pathologic mechanism of human disease as are the many effective chronotherapeutic int...

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Section: Nocturiamentioning

confidence: 96%

Circadian disruption: New clinical perspective of disease pathology and basis for chronotherapeutic intervention

Smolensky

Hermida

Reinberg

et al. 2016

Chronobiology International

151

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“…For example, nocturia, abnormal waking during the night one or more times to void, 9, 10, 11 is known to decrease quality of life and negatively affects morbidity and mortality, especially in the elderly. 12, 13, 14, 15 Possible causes of nocturia have been attributed to bladder storage problems, diurnal polyuria and nocturnal polyuria, 10 but the presence and functionality of local peripheral clocks in the regions controlling voiding functions have not yet been fully established. Recently, Herrera and Meredith (2010) observed day vs night differences in bladder capacity and voiding frequency in rats, raising the possibility that bladder function can be a direct target of circadian regulation.…”

Section: Introductionmentioning

confidence: 99%

Presence of multiple peripheral circadian oscillators in the tissues controlling voiding function in mice

et al. 2014

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Circadian clocks are the endogenous oscillators that harmonize a variety of physiological processes within the body. Although many urinary functions exhibit clear daily or circadian variation in diurnal humans and nocturnal rodents, the precise mechanisms of these variations are as yet unclear. In the present study, we demonstrate that Per2 promoter activity clearly oscillates in neonate and adult bladders cultured ex vivo from Per2::Luc knock-in mice. In subsequent experiments, we show that multiple local oscillators are operating in all the bladder tissues (detrusor, sphincter and urothelim) and the lumbar spinal cord (L4–5) but not in the pontine micturition center or the ventrolateral periaqueductal gray of the brain. Accordingly, the water intake and urine volume exhibited daily and circadian variations in young adult wild-type mice but not in Per1−/−Per2−/− mice, suggesting a functional clock-dependent nature of the micturition rhythm. Particularly in PDK mice, the water intake and urinary excretion displayed an arrhythmic pattern under constant darkness, and the amount of water consumed and excreted significantly increased compared with those of WT mice. These results suggest that local circadian clocks reside in three types of bladder tissue and the lumbar spinal cord and may have important roles in the circadian control of micturition function.

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“…A detailed discussion about the pathophysiology of nocturia is beyond the scope of this article, and multiple review articles have been written on the subject [45,46]. For the urologic conditions OAB, LUTS, IC/PBS, and CP/CPPS, the mechanisms responsible for nocturia are similar to those responsible for urinary frequency in general.…”

Section: Nocturiamentioning

confidence: 97%

Overlap of voiding symptoms among common urologic conditions

Clemens

2009

Curr Bladder Dysfunct Rep

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An overview of nocturia and the syndrome of nocturnal polyuria in the elderly

Cited by 47 publications

References 87 publications

Circadian disruption: New clinical perspective of disease pathology and basis for chronotherapeutic intervention

Circadian disruption: New clinical perspective of disease pathology and basis for chronotherapeutic intervention

Presence of multiple peripheral circadian oscillators in the tissues controlling voiding function in mice

Overlap of voiding symptoms among common urologic conditions

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