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Desmopressin treatment in nocturia; an analysis of risk factors for hyponatremia.

Rembratt, Åsa LU ; Riis, A and Norgaard, J P (2006) In Neurourology and Urodynamics 25(2). p.105-109
Abstract
Aims: To explore the incidence, severity, time course, and risk factors of clinically significant hyponatremia in desmopressin treatment for nocturia. Methods: Data from three multi-center phase 111 trials were pooled. Hyponatremia was categorised as borderline (134-130 mmol/L) or significant (<130 mmol/L). Risk factors were explored with logistic regression and subgroup analysis performed to explore threshold values for contra-indication. Results: In total 632 patients (344 men, 288 women) were analyzed. During dose-titrition, serum sodium concentration below normal range was recorded in 95 patients (15%) and 31 patients (4.9%) experienced significant hyponatremia. The risk increased with age, lower serum sodium concentration at... (More)
Aims: To explore the incidence, severity, time course, and risk factors of clinically significant hyponatremia in desmopressin treatment for nocturia. Methods: Data from three multi-center phase 111 trials were pooled. Hyponatremia was categorised as borderline (134-130 mmol/L) or significant (<130 mmol/L). Risk factors were explored with logistic regression and subgroup analysis performed to explore threshold values for contra-indication. Results: In total 632 patients (344 men, 288 women) were analyzed. During dose-titrition, serum sodium concentration below normal range was recorded in 95 patients (15%) and 31 patients (4.9%) experienced significant hyponatremia. The risk increased with age, lower serum sodium concentration at baseline, higher basal 24-hr urine volume per bodyweight and weight gain at time of minimum serum sodium concentration. Age was the best single predictor. Elderly patients (>= 65 years of age) with a baseline serum sodium concentration below normal range were at high risk (75%). Limiting treatment in elderly with normal basal serum sodium concentration to those below 79 years and with a 24-hr urine output below 28 ml/kg would reduce the risk from 8.1% to 3.0% at the cost of 34% fulfilling the contra-indication. Conclusions: The majority of nocturia patients tolerate desmopressin treatment without clinically significant hyponatremia. However, the risk increases with increasing age and decreasing baseline serum sodium concentration. Treatment of nocturia in elderly patients with desmopressin should only be undertaken together with careful monitoring of the scrum sodium concentration. Patients with a baseline serum sodium concentration below normal range should not be treated. (Less)
Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
elderly, safety, serum sodium
in
Neurourology and Urodynamics
volume
25
issue
2
pages
105 - 109
publisher
John Wiley and Sons
external identifiers
  • wos:000235896200002
  • pmid:16304673
  • scopus:33644910200
  • pmid:16304673
ISSN
0733-2467
DOI
10.1002/nau.20168
language
English
LU publication?
yes
id
526dc879-05c8-4509-b0f3-ade9c8eae874 (old id 147765)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16304673&dopt=Abstract
date added to LUP
2016-04-01 11:44:29
date last changed
2021-10-06 05:52:29
@article{526dc879-05c8-4509-b0f3-ade9c8eae874,
  abstract     = {Aims: To explore the incidence, severity, time course, and risk factors of clinically significant hyponatremia in desmopressin treatment for nocturia. Methods: Data from three multi-center phase 111 trials were pooled. Hyponatremia was categorised as borderline (134-130 mmol/L) or significant (&lt;130 mmol/L). Risk factors were explored with logistic regression and subgroup analysis performed to explore threshold values for contra-indication. Results: In total 632 patients (344 men, 288 women) were analyzed. During dose-titrition, serum sodium concentration below normal range was recorded in 95 patients (15%) and 31 patients (4.9%) experienced significant hyponatremia. The risk increased with age, lower serum sodium concentration at baseline, higher basal 24-hr urine volume per bodyweight and weight gain at time of minimum serum sodium concentration. Age was the best single predictor. Elderly patients (&gt;= 65 years of age) with a baseline serum sodium concentration below normal range were at high risk (75%). Limiting treatment in elderly with normal basal serum sodium concentration to those below 79 years and with a 24-hr urine output below 28 ml/kg would reduce the risk from 8.1% to 3.0% at the cost of 34% fulfilling the contra-indication. Conclusions: The majority of nocturia patients tolerate desmopressin treatment without clinically significant hyponatremia. However, the risk increases with increasing age and decreasing baseline serum sodium concentration. Treatment of nocturia in elderly patients with desmopressin should only be undertaken together with careful monitoring of the scrum sodium concentration. Patients with a baseline serum sodium concentration below normal range should not be treated.},
  author       = {Rembratt, Åsa and Riis, A and Norgaard, J P},
  issn         = {0733-2467},
  language     = {eng},
  number       = {2},
  pages        = {105--109},
  publisher    = {John Wiley and Sons},
  series       = {Neurourology and Urodynamics},
  title        = {Desmopressin treatment in nocturia; an analysis of risk factors for hyponatremia.},
  url          = {https://lup.lub.lu.se/search/files/2620144/625148.pdf},
  doi          = {10.1002/nau.20168},
  volume       = {25},
  year         = {2006},
}