Determining the optimal initial dose for Japanese patients with nocturnal polyuria using an initial dose of desmopressin 50 μg

IF 1.5 4区 医学 Q3 UROLOGY & NEPHROLOGY
Hirofumi Kurose, Keisuke Komiya, Naoyuki Ogasawara, Kosuke Ueda, Katsuaki Chikui, Kiyoaki Nishihara, Makoto Nakiri, Mitsunori Matsuo, Shigetaka Suekane, Tsukasa Igawa
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引用次数: 2

Abstract

Objective

There is no consistent opinion on the optimal initial dose of desmopressin for patients with nocturnal polyuria. Over a period of 12 weeks, we investigated the safety and efficacy of an initial dose of 50 μg of desmopressin for elderly men.

Methods

Eighty patients (mean age: 78.8 years) were started on an initial dose of 50 μg of desmopressin for nocturia associated with nocturnal polyuria. Safety and efficacy were evaluated after 1, 4, and 12 weeks using a frequency-volume chart, Athens Insomnia Scale, Patient Global Impression of Improvement scale, physical examination, blood tests, and a body composition analyzer.

Results

Along with reduction in the frequency and volume of night-time urination, improvements in hours of undisturbed sleep, nocturnal polyuria index, and International Prostate Symptom Score, and Overactive Bladder Symptom Scores on quality of life measures were also observed. Hyponatremia was observed in 15 patients (18.7%). However, only 5.0% of patients had hyponatremia after the dose was reduced to 25 μg, and the continuation rate at 12 weeks was high at 87.5%. Age and other physical factors, such as body mass index, body water content, body fat mass, and muscle mass were not significant predictors of adverse events.

Conclusions

Our study suggests that an initial dose of 50 μg is more effective than a uniformly minimum dose based on factors such as age and physique. Furthermore, a high continuation rate can be achieved by appropriately reducing the dose, if adverse events occur.

确定日本夜间多尿患者的最佳初始剂量,初始剂量为去氨加压素50 μg
目的对去氨加压素治疗夜间多尿患者的最佳起始剂量尚无一致的意见。在12周的时间里,我们研究了初始剂量50 μg去氨加压素对老年男性的安全性和有效性。方法80例患者(平均年龄78.8岁)初始剂量50 μg去氨加压素治疗夜尿合并多尿。在1周、4周和12周后,使用频率容积图、雅典失眠量表、患者整体改善印象量表、体格检查、血液检查和身体成分分析仪评估安全性和有效性。结果随着夜间排尿次数和排尿量的减少,未受干扰的睡眠时间、夜间多尿指数、国际前列腺症状评分和膀胱过度活跃症状评分的生活质量指标也有所改善。低钠血症15例(18.7%)。然而,在剂量降至25 μg后,只有5.0%的患者出现低钠血症,12周时的持续率高达87.5%。年龄和其他身体因素,如身体质量指数、身体含水量、身体脂肪质量和肌肉质量不是不良事件的显著预测因子。结论基于年龄和体质等因素,50 μg的初始剂量比统一的最低剂量更有效。此外,如果发生不良事件,可以通过适当减少剂量来实现高延续率。
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来源期刊
LUTS: Lower Urinary Tract Symptoms
LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-
CiteScore
3.00
自引率
7.70%
发文量
52
审稿时长
>12 weeks
期刊介绍: LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.
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