Basic or extended urine sampling to analyse urine production?

Denys, Marie‐Astrid; Kapila, Vansh; Weiss, Jeffrey P.; Goessaert, An-Sofie; Everaert, Karel

doi:10.1002/nau.23198

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…Phenotyping patients by the composition of their excess urine volume – the relevant substrate for pharmacologic interventions directed at nocturnal polyuria – carries the potential to directly facilitate individualized treatment. 155 For example, in view of the mechanism of antidiuretic replacement therapy, patients with nocturnal polyuria owing to water diuresis or a mixed phenotype would be expected to demonstrate the most robust response to treatment with desmopressin. 156 Conversely, normalization of circadian homeostasis with appropriately timed diuretic/natriuretic would likely be of particular benefit in patients with a solute-predominant phenotype.…”

Section: Emerging Technologies: Individualizing Nocturnal Polyuria Di...mentioning

confidence: 99%

Pharmacologic management of nocturnal polyuria: a contemporary assessment of efficacy, safety, and progress toward individualized treatment

Monaghan

Weiss

Everaert

et al. 2021

Therapeutic Advances in Urology

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This narrative review synthesizes current evidence on the medical management of nocturnal polyuria, including antidiuretic replacement therapy as well as other emerging modalities, with particular emphasis on areas of active investigation and future research directions. Relative to earlier formulations, the pharmacological profiles of novel desmopressin acetate nasal spray and orally disintegrating tablet formulations appear favorable in optimizing the balance between efficacy and safety. Additionally, several highly selective small-molecule arginine vasopressin 2 receptor agonists are under active development, while appropriately timed short-acting diuretics, pharmacotherapy for hypertension, nonsteroidal anti-inflammatory drugs, and sex hormone replacement therapy are also a focal point of extensive ongoing nocturnal polyuria research. Emerging laboratory technologies now make feasible a sub-stratification of nocturnal polyuria patients into substrate-based phenotypes for individualized treatment. An increasingly refined understanding of the pathogenesis of nocturnal polyuria, and arginine vasopressin dysregulation in particular, has also introduced new opportunities for point-of-care testing in patients with nocturnal polyuria.

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Section: Emerging Technologies: Individualizing Nocturnal Polyuria Di...mentioning

confidence: 99%

Pharmacologic management of nocturnal polyuria: a contemporary assessment of efficacy, safety, and progress toward individualized treatment

Monaghan

Weiss

Everaert

et al. 2021

Therapeutic Advances in Urology

Self Cite

View full text Add to dashboard Cite

show abstract

“…The management of NP may be further individualized by stratifying patients on the basis of urine composition (evidence for which may be gleaned through the comprehensive clinical assessment and corroborated with nocturnal urine sampling if necessary) [82]. There exists some evidence to suggest that NP patients with a sodium-predominant phenotype may respond to appropriately timed (i.e., morning or early afternoon) diuretics [83], which are thought to shift the circadian rhythm of urine production toward more daytime urine output [17].…”

Section: Treatment Of Npmentioning

confidence: 99%

Nocturia through the menopausal transition and beyond: a narrative review

et al. 2021

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Introduction and hypothesis Nocturia, defined as the act of waking to pass urine during sleeping, is a common problem in older women and is associated with significant morbidity and impairments in health-related quality of life. The aim of this review was to synthesize the current evidence regarding the incidence, impact, pathophysiology, and specific diagnostic approach of nocturia in the postmenopausal population. Methods We searched PubMed and Web of Science databases to identify relevant studies published through June 2020. Reference lists of the reviews obtained were screened for other articles deemed pertinent by the authors. Results Genitourinary symptoms attributed to the menopause have been reported to occur in nearly 90% of postmenopausal women, and nocturia is one of the most common. The relative deficiency in endogenous estrogen production after the menopause is thought to exacerbate all major pathophysiological mechanisms that may underlie nocturia, including reduced bladder capacity, nocturnal polyuria, global polyuria, and sleep disorders. Diminished estrogen may induce anatomical and physiological bladder changes, contributing to a reduction in functional bladder capacity. Excess nocturnal urine production can also be provoked by estrogen depletion, either via free water-predominant diuresis by an impaired secretion of antidiuretic hormone, or a salt-predominant diuresis owing to diminished activation of the renin-angiotensin-aldosterone axis. Additionally, a relationship between the transition to menopause and impaired sleep has been described, mediated by increased incidence in vasomotor symptoms and obstructive sleep apnea signs during the menopause. Conclusion Further research is necessary to better characterize and manage nocturia in postmenopausal women.

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Basic or extended urine sampling to analyse urine production?

Cited by 2 publications

References 18 publications

Pharmacologic management of nocturnal polyuria: a contemporary assessment of efficacy, safety, and progress toward individualized treatment

Pharmacologic management of nocturnal polyuria: a contemporary assessment of efficacy, safety, and progress toward individualized treatment

Nocturia through the menopausal transition and beyond: a narrative review

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