Possible Role of Prostaglandins in Pathogenesis of Nocturnal Enuresis in Children

Aa, Kuznetsova; Ei, Shakhmatova; Np, Prutskova; Natochin, Yu. V.

doi:10.1080/003655900750016841

Cited by 24 publications

(11 citation statements)

References 7 publications

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“…The initial findings of decreased vasopressin (AVP) levels 11 associated with increased urine production with low osmolality overnight were recently 12 confirmed 7,8 . Due to the reduction of nocturnal polyuria and enuresis by the vasopressin 13 analogue desmopressin (1-desamino-8-D-arginine vasopressin) (dDAVP), the decreased 14 nocturnal vasopressin secretion hypothesis became widely accepted 1 . 15 Although evidence based results show superiority of dDAVP above placebo, only 30 % of 16 patients reach complete continence, suggesting that probably not all patients with MNE have 17 polyuria or are dDAVP-responsive 7,9 .…”

Section: Introductionmentioning

confidence: 99%

Circadian Rhythm of Glomerular Filtration and Solute Handling Related to Nocturnal Enuresis

et al. 2016

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We will provide journalists and editors with full-text copies of the articles in question prior to the embargo date so that stories can be adequately researched and written. The standard embargo time is 12:01 AM ET on that date. Questions regarding embargo should be directed to jumedia@elsevier.com. Abstract PURPOSEAlthough nocturnal polyuria in monosymptomatic enuresis (MNE) can largely be explained by the decreased nocturnal vasopressin secretion hypothesis, other circadian rhythms in the kidney also seem to play a role.Recently we documented an absent day/night rhythm in a subgroup of desmopressin (dDAVP) -refractory patients. The aim of this study was to explore the importance of abnormal circadian rhythm of glomerular filtration (GFR) and tubular (sodium, potassium) parameters in patients with MNE. MATERIALS AND METHODSThis retrospective study of a tertiary enuresis population collected data subsequent to a standardized screening (ICCS questionnaire, diary), 14 days diary for nocturnal enuresis and diuresis, and 24h concentration profile. The study population consisted of 139 children with nocturnal enuresis (NE) at least 5 years of age. The group of NMNE was used as control population for the children with MNE. RESULTSThere was a maintained circadian rhythm of GFR, sodium, osmotic excretion and diuresis-rate in both children with MNE and NMNE and there was no difference between the two groups. Secondary analysis revealed that in patients with nocturnal polyuria (both with MNE and NMNE), circadian rhythm of GFR, sodium, osmotic excretion and diuresis-rate was lost in contrast with patients without nocturnal polyuria (p<0.001). CONCLUSIONSCircadian rhythm of the kidney is not different between NMNE and MNE. However the subgroup of enuresis with nocturnal polyuria has a diminished circadian rhythm of nocturnal diuresis, sodiumexcretion and GFR in contrast with children without nocturnal polyuria. This observation cannot be explained by the vasopressin theory alone.

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Section: Introductionmentioning

confidence: 99%

Circadian Rhythm of Glomerular Filtration and Solute Handling Related to Nocturnal Enuresis

et al. 2016

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“…The problem was solved not only for the case of nocturnal enuresis in children but also as the more general problem of the physiological regulation of renal functions in humans. An increase in the renal excretion of autacoids was found [14]. This increase correlated with an increase both in the excretion of osmotically active substances, in particular, sodium ions, and in the reabsorption of solute-free water.…”

Section: Resultsmentioning

confidence: 90%

“…This increase correlated with an increase both in the excretion of osmotically active substances, in particular, sodium ions, and in the reabsorption of solute-free water. In this case, prostaglandin Ö 2 was one of the autacoids [14]. Prostaglandin E 2 is known to inhibit the effect of vasopressin, and its increased secretion can be expected to decrease the reabsorption of solute-free water.…”

Section: Resultsmentioning

confidence: 97%

Clinical Physiology: Role in Studying Basic Problems of the Regulation of Renal Functions in Humans

IuV

2005

Hum Physiol

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In many cases, man is an object of physiological studies. Physiological branches that investigate human functions include the physiology of individual organs and systems (in particular, the physiology of respiration, circulation, the heart, and the kidney), ecological physiology, labor physiology, space physiology, sports physiology, and extreme state physiology. In these cases, studies focus on the functions of a healthy human body. The efforts of pathophysiologists are concentrated on the study of the vital activities of the body in a state of disease [1,2]: pathophysiology studies the most general features of functional disorders in cells, organs, and the whole body in disease ([3], p. 18). Physiology must comprehend the mechanisms of functions in the body as a whole, and data from each of the above branches of physiology can contribute to the solution of the basic problems of physiology, which is a prerequisite for the solution of applied problems and is essential for medicine and for the optimization of approaches to human adaptation to varying environmental conditions.In addition to normal and pathological physiology, progress is being made in the area of clinical physiology, a field of science whose purpose is to investigate the role and character of changes in physiological processes under premorbid and morbid conditions of the body ([4], p. 186). Clinical physiology must characterize the physiological processes that occur during the development of morbid conditions ([5], p. 3), elucidate the mechanisms whereby the disturbed functions are compensated ([5], p. 4), and describe the functions in the presence of a given disease and under changing environmental conditions. However, it seems important to focus attention on an aspect of clinical physiology that the present author failed to find in the literature, and it is with this aspect that the present paper will mainly be concerned. This aspect renders clinical physiology the one and only approach to the solution of the fundamental problems of human physiology and general physiology. This approach is unique because man is the object of study and the test procedure is determined by a complex of factors influencing man rather than designed by a physiologist. These factors comprise previous life conditions or inborn defects resulting in the deviation of functions from normal. This concept includes innumerable states when the body's viability is retained but the physiological systems are unable to provide for compensation even under minor changes in environmental conditions. The present work was designed to study the potentialities of clinical physiology for the detection of new aspects in the physiological regulation of renal functions in humans, namely, the aspects that are inaccessible to other branches of physiology. METHODSDescription of the subjects, including their age and conditions of blood and urine sampling, was presented in the works mentioned in the text. In all cases, blood samples were taken after fasting from the antecubital vein before 9:30 a.m...

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“…Although these theories, which include behavioral, developmental, psychological, genetic, neurological, urodynamic, and organic causes, are diverse and may be able to explain selected cases, there is no single explanation for nocturnal enuresis [2,3]. Clearly, the vast majority of children with nocturnal enuresis do not suffer from psychiatric, neurological, or urologic disturbances, and investigation along these lines was worthless.…”

Section: Discussionmentioning

confidence: 98%

“…Recent research has helped to correct some traditional misconceptions and unveil the underlying pathophysiological mechanisms. It has been demonstrated that nocturnal enuresis is a heterogeneous disorder with various pathophysiological causes, resulting in a mismatch between the nocturnal bladder capacity and the amount or urine produced during sleep at night, in association with a simultaneous failure of conscious arousal in response to the sensation of bladder fullness [2]. Nowadays, nocturnal enuresis is not considered a self-limited condition, but a disease that necessitates appropriate diagnostic and therapeutic work-up.…”

Section: Introductionmentioning

confidence: 99%

Management of nocturnal enuresis in Greek children

et al. 2005

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Our experiences of managing nocturnal enuresis in Greek children at our Outpatient Clinics of Pediatric Urology are described. Between March 2001 and October 2003, 142 children with primary nocturnal enuresis (93 boys and 49 girls), aged 7-18 years old (mean: 9.0+/-0.5) were included in this prospective study. Initially, behavioral conditioning therapy, using a body-worn urinary alarm, was instructed in all cases. If no improvement was recorded, 40 microg of intranasal desmopressin was administered, initially for three months. If urodynamic studies demonstrated pure detrusor instability, anticholinergics (5 mg oxybutinine or 2 mg tolterodine) were given instead. Combination medication (desmopressin and anticholinergics) was administered for coexisting diurnal enuresis, which was present in 8 children. Among the 142 children the overall response rate was 51.41%. Successful response was recorded in 16 children practicing conditioning behavioral therapy, in 47 receiving desmopressin (with or without anticholinergics), and in 10 children receiving only anticholinergics. During the follow-up period (mean: 6.2 months), no serious side effect was recorded. The use of desmopressin, and anticholinergics in specific subgroups, was found to be effective and safe for the management of nocturnal enuresis in children.

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Possible Role of Prostaglandins in Pathogenesis of Nocturnal Enuresis in Children

Abstract: The results of the study suggest that changes in renal function are due not to a higher secretion of prostaglandins in nocturnal enuresis but to the relative dominance of their effect as compared with other physiologically active substances that simultaneously act on renal tubular cells.

Cited by 24 publications

References 7 publications

Circadian Rhythm of Glomerular Filtration and Solute Handling Related to Nocturnal Enuresis

Circadian Rhythm of Glomerular Filtration and Solute Handling Related to Nocturnal Enuresis

Clinical Physiology: Role in Studying Basic Problems of the Regulation of Renal Functions in Humans

Management of nocturnal enuresis in Greek children

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