Serum Sodium Alterations in Children with Primary Monosymptomatic Nocturnal Enuresis Using Desmopressin
| Author | Ehsan Valavi | en |
| Author | Azar Nickavar | en |
| Author | Parisa Amoori | en |
| Author | Sadrodin Raiszadeh | en |
| Orcid | Ehsan Valavi [0000-0001-5088-2054] | en |
| Orcid | Azar Nickavar [0000-0003-0740-0667] | en |
| Orcid | Parisa Amoori [0000-0002-4638-7920] | en |
| Orcid | Sadrodin Raiszadeh [0000-0001-5413-9364] | en |
| Issued Date | 2022-08-31 | en |
| Abstract | Background: Hyponatremia/water intoxication has been considered a rare but serious complication of desmopressin (DDAVP) for the treatment of primary monosymptomatic nocturnal enuresis (PMNE). Objectives: This study aimed to identify the incidence and risk factors of serum sodium (Na) alterations in children with PMNE treated with oral or intranasal DDAVP. Methods: A total of 201 patients with PMNE were evaluated in 2 groups using intranasal (n = 127) or oral DDAVP (n = 74) for approximately 6 months. Treatment efficacy was defined as a more than 50% decrease in wet nights after 1 month of treatment. Serum Na was measured before, during, and after treatment in all patients. Predisposing factors of serum Na disturbance were evaluated concomitantly. Results: The mean age of patients was 8.8 ± 2.6 (5 - 17.5) years, and males outnumbered females (M/F = 1.68). Treatment efficacy was 100% in 93 (46.2%), and > 90% in 157 (78.1%) cases. Oral DDAVP had significantly more therapeutic effects than intranasal treatment (P = 0.024). However, serum Na had no significant difference between the 2 groups (P = 0.52). Hyponatremia occurred in 7 (3.5%) patients (3 in oral treatment and 4 in intranasal treatment; P = 0.73) with no significant correlation to age, gender, body weight, frequency of enuresis, and initial serum Na. However, decreased serum Na > 5 mEq/L was a significant risk factor for the prediction of hyponatremia in our patients (P < 0.001). Conclusions: Oral DDAVP had more therapeutic effects than intranasal treatment for the treatment of PMNE. 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. As a suggestion, monitoring serum Na is not an essential follow-up in asymptomatic patients in DDAVP treatment. | en |
| DOI | https://doi.org/10.5812/numonthly-126626 | en |
| Keyword | Nocturnal Enuresis | en |
| Keyword | Desmopressin | en |
| Keyword | Hyponatremia | en |
| Keyword | Children | en |
| Publisher | Brieflands | en |
| Title | Serum Sodium Alterations in Children with Primary Monosymptomatic Nocturnal Enuresis Using Desmopressin | en |
| Type | Research Article | en |
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