![]() ![]() Data were extracted from the pediatric professional thesis (license code: CRD-9805), and informed consent was obtained from the children’s legal guardians at the time of the project. Link: .ir/EthicsProposalView.php?id=121453). The Ethics Committee of Ahvaz Jundishapur University of Medical Sciences approved this study (code: IR.AJUMS.REC.1398.906. Therefore, monitoring of serum sodium (Na) has been suggested for the prevention of hyponatremia in some studies ( 5, 8, 9).Īccording to the controversial reports of hyponatremia, this study was performed to identify the incidence and risk factors of hyponatremia in children treated with oral or intranasal DDAVP.Ī total of 201 patients with PMNE were enrolled in this cross-sectional study from 2019 to 2021. However, hyponatremia has been suggested as a potentially serious adverse effect of DDAVP 14 days or less after the beginning of the treatment ( 3, 4, 6- 8) Hyponatremia/water intoxication might occur in 12% - 22% of patients, more common after intranasal treatment. Various pharmaceutical formulations of DDAVP have been commercialized, including nasal spray, nasal drops, and oral tablets ( 7).ĭDAVP is a generally effective, safe, and well-tolerated drug. It has been shown to be an effective treatment of nocturnal polyuria by decreasing nocturnal urine production ( 3, 7).Ībout 60% - 70% of children with PMNE have a complete or partial response to DDAVP, which is most pronounced in children older than 8 years with monosymptomatic nocturnal polyuria, normal bladder capacity, and less frequent bed-wetting without daytime symptoms ( 5). Lines of evidence suggest central nervous system dysfunction in ADH mechanism in children with primary PMNE ( 5, 6).ĭesmopressin (DDAVP), 1-deamino-8-D-arginine vasopressin, is a synthetic analog of arginine vasopressin (AVP) with a more potent antidiuretic effect than AVP. Serum ADH decreases urine volume excretion by increasing water reabsorption from the distal nephron, especially during bedtime. ![]() ![]() It is the most common pediatric urological developmental disorder, which occurs in up to 20% of children aged 5 years and is 3 times more common in boys than girls ( 1, 2)ĭifferent pathogenic mechanisms have been recognized in children with PMNE, including (1) nocturnal polyuria with sleep urine volume > 35% of the total 24-hour urine output, secondary to the insufficient nocturnal increase of serum antidiuretic hormone (ADH) (2) decreased nocturnal functional bladder capacity (3) primary sleep disorders and (4) mixed nocturia ( 3, 4) Primary monosymptomatic nocturnal enuresis (PMNE) is defined as the repeated voiding of urine during bedtime for at least 3 consecutive months in 5-year-old children who have not been dry for > 6 months. Nocturnal Enuresis Desmopressin Hyponatremia Children 1. As a suggestion, monitoring serum Na is not an essential follow-up in asymptomatic patients in DDAVP treatment. Serum Na had no significant alteration in both oral and intranasal treatments, and hyponatremia was a rare complication of DDAVP, which occurred significantly in children with a > 5-mEq/L decrease of initial serum Na concentration. Oral DDAVP had more therapeutic effects than intranasal treatment for the treatment of PMNE. ![]()
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