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Future Considerations in Nocturia and Nocturnal Polyuria - 05/11/19

Doi : 10.1016/j.urology.2019.06.014 
Jeffrey P. Weiss a, , Thomas F. Monaghan a, Matthew R. Epstein a, Jason M. Lazar b
a Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY 
b Department of Medicine, Division of Cardiovascular Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY 

Address correspondence to: Jeffrey P. Weiss M.D., Department of Urology, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Box 79, Brooklyn, NY 11203.Department of UrologySUNY Downstate Health Sciences University450 Clarkson Avenue, Box 79BrooklynNY11203

Abstract

Nocturnal polyuria (NP), the most common etiology of nocturia, can be caused by various medical conditions, including cardiovascular disease, obstructive sleep apnea, renal tubular dysfunction, as well as medications (eg, diuretics) and/or behavioral patterns. NP in the absence of underlying medical conditions has been described as NP syndrome and is thought be the result of impaired circadian release of endogenous arginine vasopressin. Desmopressin, a synthetic arginine vasopressin analog, has been shown to be an effective replacement therapy in adults with nocturia due to NP. Further studies on the subset of patients with NP syndrome are warranted to maximize benefit from antidiuretic treatment. In addition, a connection between the pathophysiological mechanisms underlying NP and essential hypertension has been suggested, and hypertension has been shown to be a significant risk factor for nocturia, while an association between NP and brain natriuretic peptide levels has also been reported in patients with nocturia. Hypertension is now viewed as a disorder of blood vessels and treatment is directed at the vasculature rather than the blood pressure, with the latter currently serving as a biomarker for arterial injury. Nocturia is thought to be associated with the beginning of this cardiovascular continuum as studies have reported a link between coronary heart disease and nocturia. Therefore, there is an increasing need to elucidate the complex mechanisms implicated in the association between nocturia and hypertension to promote the development of more individualized therapies for the treatment of nocturia.

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 Conflict of Interest: Jeffrey P Weiss reports personal fees from Ferring and the Institute for Bladder and Prostate Research, outside the submitted work. Jason Lazar, Thomas F Monaghan, and Matthew R Epstein have no declarations of interest to disclose.
 Financial Disclosure: Jeffrey P Weiss and Jason Lazar received honoraria from IQVIA for their participation in a roundtable meeting supported by a grant fromFerring Pharmaceuticals.
 Disclosure Statement: This paper is part of a Supplement funded by a grant from Ferring Pharmaceuticals.
 Presentations and discussions were developed solely by the participants, without grantor input. The meeting chair, Jeffrey P Weiss, determined the agenda and attendees. Jeffrey P Weiss and Jason Lazar developed the presentations and, together with Thomas F Monaghan and Matthew R Epstein, led the discussions upon which this article is based, provided critical review and revisions to the outline and manuscript drafts, provided final approval of the version to be published, and are accountable for the integrity of the content and for addressing questions.


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Vol 133 - N° S

P. 34-42 - novembre 2019 Retour au numéro
Article précédent Article précédent
  • Management of Nocturia and Nocturnal Polyuria
  • Jeffrey P. Weiss, Karel Everaert

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