Dietary Sodium Restriction Reduces Nocturnal Urine Volume and Nocturnal Polyuria Index in Renal Allograft Recipients With Nocturnal Polyuria

Okumura, Yoshinaga; Asai, Kanae; Kobayashi, Takashi; Miyata, Hirofumi; Tanaka, Yukari; Okada, Yoshiyuki; Sakai, Kaoru; Kamba, Tomomi; Tsuji, Hideaki; Shide, Kenichiro; Nagashima, Kazuaki; Yanagita, Motoko; Inagaki, Nobuya; Ogawa, Osamu; Negoro, Hiromitsu

doi:10.1016/j.urology.2017.04.025

Cited by 8 publications

(10 citation statements)

References 22 publications

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“…For clinical practice, these results suggest that subjects with fluctuating nocturia frequency may benefit from treatments that target nocturnal urine output in order to avoid nights with high numbers of nocturnal voids. Previous studies demonstrated that this can be obtained by pharmaceutical treatments and conservative measures, such as fluid restriction during the evening, leg elevation during daytime, or sodium‐restricting measures . However, our study showed that rather an increased daytime fluid intake than an increase in evening fluid intake was linked to increasing nocturia severity, which suggests that rather a reduction in daytime fluid intake may avoid high nocturia severity.…”

Section: Discussioncontrasting

confidence: 73%

“…Previous studies demonstrated that this can be obtained by pharmaceutical treatments and conservative measures, such as fluid restriction during the evening, leg elevation during daytime, or sodium-restricting measures. 2,14,15 However, our study showed that rather an increased daytime fluid intake than an increase in evening fluid intake was linked to increasing nocturia severity, which suggests that rather a reduction in daytime fluid intake may avoid high nocturia severity. Such a measure will not encourage patients to maintain a normal bladder capacity and may increase urine concentration, leading to bladder irritation and an increased incidence of LUTS and urinary tract infections.…”

Section: Discussioncontrasting

confidence: 55%

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A different way to study frequency volume charts in patients with nocturia

Denys

Goessaert

Dejaeghere

et al. 2017

Neurourology and Urodynamics

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Section: Discussioncontrasting

confidence: 73%

Section: Discussioncontrasting

confidence: 55%

A different way to study frequency volume charts in patients with nocturia

Denys

Goessaert

Dejaeghere

et al. 2017

Neurourology and Urodynamics

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“…Identified studies were meta‐analyses (n = 1), RCTs (n = 3), prospective cohort studies (n = 4), retrospective case–control studies (n = 1), cross‐sectional studies (n = 27), case–control studies (n = 1), post hoc analyses of RCTs (n = 2), and quasi‐experimental studies (n = 3). Three studies assessed morbidity outcomes, two studies assessed outcomes related to symptoms/quality of life/functional status, 31 studies assessed clinically relevant surrogate outcomes, including 26 that assessed blood pressure outcomes, and six studies assessed physiologic outcomes . Of these studies, only three studies met the minimum methodological criteria for detailed critical appraisal (Table ).…”

Section: Resultsmentioning

confidence: 99%

Paucity of high‐quality studies reporting on salt and health outcomes from the science of salt: A regularly updated systematic review of salt and health outcomes (April 2017 to March 2018)

Petersen

Rae

Venos

et al. 2018

J of Clinical Hypertension

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The purpose of this review is to identify, summarize, and critically appraise studies on dietary salt and health outcomes that were published from April 2017 to March 2018. The search strategy was adapted from a previous systematic review on dietary salt and health. Identified studies were screened based on a priori defined criteria to identify publications eligible for detailed critical appraisals. Overall, 6747 citations were identified by the search strategy, and 42 health outcome studies were identified. Three of the 42 studies met the criteria for methodological quality and health outcomes and underwent detailed critical appraisals and commentary. In addition, a systematic review and meta-analysis was critically appraised, although it did not strictly meet our methodological criteria. All four of the studies critically appraised found that sodium reduction improved blood pressure, especially in individuals with hypertension. In addition, sodium reduction reduced albuminuria in patients with stage 1-3 chronic kidney disease. Examination of the time course of blood pressure responses to sodium reduction revealed lowering sodium in the context of an average American diet may not produce maximal blood pressure reductions within a 4week intervention period. This review provides further evidence of the benefit of sodium reduction for blood pressure lowering and gives insights into the subgroups of the population that may derive the greatest benefit from sodium reduction and the

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“…For instance, patients with a sodium-predominant NP phenotype may benefit from dietary sodium restriction, daytime loop diuretic use, or therapies aimed at reducing third spacing before bed, such as exercise and/or compression stockings. [17][18][19] Conversely, in the absence of identifiable secondary conditions, patients with free waterpredominant NP refractory to nighttime fluid restriction may benefit from antidiuretic replacement therapy. 20 More recently, Goessaert et al 21 reported a surge in free water clearance during the early nocturnal period among subjects with NP, whereas solute clearance was observed to predominate during the later nocturnal period.…”

Section: Resultsmentioning

confidence: 99%

Time of peak nocturnal diuresis rate between men with secondary nocturnal polyuria versus nocturnal polyuria syndrome

Monaghan

Epstein

Bliwise

et al. 2020

Neurourology and Urodynamics

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Aim: Compare the circadian trajectory of diuresis between nocturnal polyuria (NP) patients with versus without identifiable contributory comorbidities. Methods: Retrospective analysis of frequency-volume charts from male patients with clinically-significant nocturia (≥2 nocturnal voids) and NP (defined by nocturnal urine production [NUP] ≥90 mL/hour or nocturnal polyuria index [NPi] ≥0.33). Patients with NP and chronic kidney disease, congestive heart failure, and/or undertreated obstructive sleep apnea (OSA) were deemed to have secondary NP. Nocturnal polyuria syndrome (NPS) was defined as NP without edema, loop diuretic use, or the aforementioned conditions. Patients with diabetes insipidus or OSA with appropriate continuous positive airway pressure utilization were excluded. The timing and volumes of nocturnal voids were used to derive "early" and "late" nocturnal diuresis rates (mL/hour of urine produced before and after the first nocturnal awakening, respectively). The likelihood of an early peak nocturnal diuresis rate (ie, early >late nocturnal diuresis rate) was compared between patients with NPS versus secondary NP using both a crude and adjusted odds ratio. Results: The likelihood of an early peak nocturnal diuresis rate in patients with NPS compared with secondary NP was 2.58 (1.05-6.31) at NUP ≥ 90 mL/hour and 1. 96 (0.87-4.42) at NPi ≥ 0.33 on crude analysis, and 2.44 (0.96-6.24) and 1.93 (0.83-4.48) after adjustment, respectively.Conclusions: A peak early nocturnal diuresis rate was significantly more likely in patients with NPS at NUP ≥ 90 mL/hour, with similar odds ratios at NPi ≥ 0.33 and following adjustment. Delineating nocturic patients by NP subgroup may facilitate more individualized management.

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Dietary Sodium Restriction Reduces Nocturnal Urine Volume and Nocturnal Polyuria Index in Renal Allograft Recipients With Nocturnal Polyuria

Cited by 8 publications

References 22 publications

A different way to study frequency volume charts in patients with nocturia

A different way to study frequency volume charts in patients with nocturia

Paucity of high‐quality studies reporting on salt and health outcomes from the science of salt: A regularly updated systematic review of salt and health outcomes (April 2017 to March 2018)

Time of peak nocturnal diuresis rate between men with secondary nocturnal polyuria versus nocturnal polyuria syndrome

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