Early Serum Sodium Changes in Elderly Patients with Nocturia Receiving Desmopressin

Abstract

Abstract Background In spite of its prevalence underestimated, nocturia is in fact an extremely common condition that has considerable impact on quality of life and health outcomes, especially in the elderly. It can be caused by a variety of factors; the pathogenesis of nocturia is complex and sometimes multifactorial, involving several organ systems. Aim of the Work The aim of this study is to determine early serum sodium changes in elderly patients with nocturia receiving Desmopressin. Patients and Methods This prospective cohort design study was conducted on 28 patients aging 55 years or more complaining of nocturia and receiving desmopressin at Ain shams university hospitals starting From February 2018 till July 2018. Results Desmopressin caused a significant reduction in nocturnal urine volume, nocturnal polyuria index (NPI), number of nocturnal voids and delay in the time of first void with a statistically insignificant drop in sodium level (2%) among males and a statistically significant drop in sodium level (3.1%) among females with infrequent side effects e.g., hyponatremia (7.14%) and headache (10.7%) that occurred after one week from treatment initiation. Conclusion The incidence of hyponatraemia can be reduced by using minimum effective dose of desmopressin. A sodium monitoring plan must be proposed with baseline sodium must be ≥ 135 mmol/L (especially in elderly), with additional monitoring at week 2,3 and 4 for those at high risk of developing hyponatremia specially those aged ≥ 65 years or receiving concomitant medication inducing hyponatraemia. This monitoring plan can help to prevent some high risk patients from developing hyponatraemia.