Role of Atrial Natriuretic Peptide in Nocturnal Polyuria in Elderly Males

Carter, P.G.; Cannon, Andréa; McConnell, Athena; Abrams, Paul

doi:10.1159/000068000

Cited by 40 publications

(46 citation statements)

References 21 publications

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“…It has been suggested that salt intake has been one of the most pivotal environmental factor in the pathogenesis of hypertension. 8,27 The increased nocturnal sodium excretion in elderly patients with nocturnal polyuria suggests that there may be an underlying disturbance of sodium homoeostasis, which is consistent with a report that indicators of subclinical heart failure-raised plasma concentration of atrial natriuretic peptide and increased cardiothoracic ratio on radiography-are more common in elderly patients with nocturnal polyuria than in controls. In such patients, the redistribution of edema fluid to the vascular compartment at night could cause nocturnal polyuria.…”

Section: Discussionsupporting

confidence: 86%

Central hemodynamics, vascular stiffness, and nocturia in patients with type 2 diabetes

Afsar

Elsürer

2015

Renal Failure

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Recently, studies have shown that the presence of nocturia may not be a benign condition and related with systemic illness and mortality. Elevated blood pressure (BP) was another factor related with nocturia. Type 2 diabetes mellitus (T2DM) is also associated with nocturia. It is now clear that, apart from peripheral BP, central hemodynamic parameters are important for cardiovascular prognosis. However, no previous study in the literature examined the relationship between nocturia and central hemodynamic parameters in patients with T2DM. The current study was designed to examine these relationships. Nocturia was defined as two or more voids per night. Central hemodynamic parameters were assessed from ambulatory BP measurements. In addition to routine biochemistry, 24-h urine collection was performed to measure protein, albumin, and sodium excretion. 158 patients (52.3%) had T2DM and 144 (47.7%) did not have T2DM (control group). The presence of T2DM was independently related with nocturia. Both in whole group and in T2DM patients, most of the hemodynamic parameters are higher in patients with nocturia compared to patients without nocturia. Among patients with T2DM, nocturia was associated with augmentation index and pulse wave velocity. In conclusion, central hemodynamic parameters and markers of vascular stiffness may be related with nocturia in patients with T2DM.

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Section: Discussionsupporting

confidence: 86%

Central hemodynamics, vascular stiffness, and nocturia in patients with type 2 diabetes

Afsar

Elsürer

2015

Renal Failure

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“…By analysing the additional information contained in the FVCs nocturnal polyuria was also shown to be common among older women in the community, particularly the elderly. One of the proposed causes for nocturnal polyuria is subclinical cardiac failure [14], and it might therefore be supposed that there would be an association between diuretic use and nocturnal polyuria. This did not appear to be the case in the present study, although this has been described in men [29].…”

Section: Discussionmentioning

confidence: 99%

“…This definition has been used in previous studies [14], although other definitions have included the voiding of >35% of the total 24 h output of urine overnight [15] and the comparison of voided volumes during 12-h periods overnight with a similar period during the day [16].…”

Section: Introductionmentioning

confidence: 99%

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Nocturnal polyuria in community‐dwelling women

2004

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OBJECTIVETo determine the age prevalence of nocturnal polyuria among older women in the community, and to investigate the relationship between nocturnal polyuria and nocturia. PATIENTS AND METHODSIn all, 1183 women aged ≥50 years, who were registered with a family doctor practice and who had taken part in a prevalence study, were sent brief questionnaires and a frequency/volume chart (FVC) to complete. RESULTSThere were 227 FVCs with adequate data and 264 completed questionnaires available for analysis. The prevalence of nocturnal polyuria increased disproportionately with age. There was no clear relationship between nocturia or nocturnal polyuria and daytime frequency, nor was there a clear relationship between diuretic use and nocturnal polyuria. CONCLUSIONNocturnal polyuria is common among women in the community and not obviously related to daytime frequency. Night-time symptoms are common in women as well as men, and are troublesome to them.

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“…And although increased ANP levels have been described in the older population with NP, other studies do not observe significant differences in natriuretic peptide levels between NP patients and controls, both without cardiac failure. This suggests that NP might be a sign of undetected cardiac failure in older persons [49,50].…”

Section: Np Pathophysiologymentioning

confidence: 98%

Hormones and Nocturia: Guidelines for Medical Treatment?

Goessaert

Johan²,

Walle³

et al. 2013

J Steroids Horm Sci

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Nocturnal polyuria (NP) is an important cause of nocturia and it is related to an imbalance in water and/or sodium homeostasis. Antidiuretic hormone (ADH) and atrial natriuretic peptide (ANP) are believed to play an important role in this excessive urine production overnight, however, many other hormones are involved. ADH and ANP are both directly and indirectly influenced by the renin-angiotensin-aldosterone system (RAAS), prostaglandins antagonize both ADH and RAAS and sex hormones have a predominantly antidiuretic effect by stimulating ADH and RAAS, meaning that any disturbance can lead to an imbalance in diuresis. Since nocturia is a condition affecting sleep, melatonin secretion can also be affected, leading to a decrease in the antidiuretic effect and to an increase of nocturnal urine production. Depending on the underlying condition affecting any of these hormones, a more specific therapeutic approach might lead to a restoration of the normal diuresis cycle and to a good night's sleep. The characteristics of each of these hormones, the pathophysiology in NP and the therapeutic implications are set out in this review.

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Role of Atrial Natriuretic Peptide in Nocturnal Polyuria in Elderly Males

Cited by 40 publications

References 21 publications

Central hemodynamics, vascular stiffness, and nocturia in patients with type 2 diabetes

Central hemodynamics, vascular stiffness, and nocturia in patients with type 2 diabetes

Nocturnal polyuria in community‐dwelling women

Hormones and Nocturia: Guidelines for Medical Treatment?

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