Desmopressin is an Effective Treatment for Mixed Nocturia with Nocturnal Polyuria and Decreased Nocturnal Bladder Capacity

Abstract

To investigate the efficacy and safety of desmopressin in patients with mixed nocturia, Patients aged ≥18 yr with mixed nocturia (≥2 voids/night and a nocturnal polyuria index [NPi] >33% and a nocturnal bladder capacity index [NBCi] >1) were recruited. The optimum dose of oral desmopressin was determined during a 3-week dose-titration period and the determined dose was maintained for 4 weeks. The efficacy was assessed by the frequency-volume charts and the sleep questionnaire. The primary endpoint was the proportion of patients with a 50% or greater reduction in the number of nocturnal voids (NV) compared with baseline. Among 103 patients enrolled, 94 (79 men and 15 women) were included in the analysis. The proportion of patients with a 50% or greater reduction in NV was 68 (72%). The mean number of NV decreased significantly (3.20 to 1.34) and the mean nocturnal urine volume, nocturia index, NPi, and NBCi decreased significantly. The mean duration of sleep until the first NV was prolonged from 118.4±44.1 to 220.3±90.7 min (P<0.001). The overall impression of patients about their quality of sleep improved. Adverse events occurred in 6 patients, including one asymptomatic hyponatremia. Desmopressin is an effective and well-tolerated treatment for mixed nocturia.

Qualitative detection of desmopressin in plasma by liquid chromatography–tandem mass spectrometry

“…The data acquisition rate was 1 Hz. 8 In order to get additional information on the MS behavior of desmopressin, reduction of the disulfide bridge (Mpa1-Cys6) was performed by adding 200 µl of dithiothreitol in 0.2 mM ammonium acetate buffer at pH=5.5 (both from Sigma-Aldrich) to readily prepared solutions of the peptide and incubating the resulting solution for 30 minutes at 56 °C.…”

“…The contemporary presence in fragment ion y 3 of Arg 8 and Pro 6 at the N-terminal, which usually causes enhanced fragmentation attributed to the greater basicity of prolin substituted nitrogen group [29], can explain the elevated abundance of this fragment in the MRM mode.…”

“…These methods provided sensitive and cost effective analyses [8,[18][19][20][21][22], but with some important limitations, in particular concerning specificity [23].…”

“…Desmopressin is therapeutically used for the treatment of diabetes insipidus [4; 5], primary nocturnal enuresis (bed wetting) [6][7][8][9] type I von Willebrand disease, and hemophilia A [11][12][13][14].…”

Clinical efficiency of desmopressin and cyclooxygenase inhibitor use in incontinent women

“…Вместе с тем появились данные об эффек тивном применении в ряде случаев антидиуретического гормона [23][24][25][26][27][28] как для лечения недержания мочи, так и для коррек-ции избыточного мочеобразования у пациен-тов с никтурией в основном пожилого возрас-та, поскольку при старении снижается уровень секреции антидиуретического гормона, что ве-дет, наряду со снижением концентрационной способности почек, к избыточному мочеобра-зованию [16]. В 2011 г. Европейская ассоциация урологов одобрила применение синтетического аналога антидиуретического гормона десмо-прессина для лечения никтурии [29].…”