MP02-03 NOCTURNAL URINE SAMPLING AS A PATIENT-CENTERED ALTERNATIVE TO VOIDING DIARIES IN THE DIAGNOSIS OF NOCTURNAL POLYURIA

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making I (MP02)1 Apr 2020MP02-03 NOCTURNAL URINE SAMPLING AS A PATIENT-CENTERED ALTERNATIVE TO VOIDING DIARIES IN THE DIAGNOSIS OF NOCTURNAL POLYURIA Thomas Monaghan*, Joseph Verbalis, Rebecca Haddad, Kim Pauwaert, Christina Agudelo, An-Sofie Goessaert, Denys Marie-Astrid, Jason Lazar, Donald Bliwise, Johan Vande Walle, Alan Wein, Jeffrey Weiss, and Karel Everaert Thomas Monaghan*Thomas Monaghan* More articles by this author , Joseph VerbalisJoseph Verbalis More articles by this author , Rebecca HaddadRebecca Haddad More articles by this author , Kim PauwaertKim Pauwaert More articles by this author , Christina AgudeloChristina Agudelo More articles by this author , An-Sofie GoessaertAn-Sofie Goessaert More articles by this author , Denys Marie-AstridDenys Marie-Astrid More articles by this author , Jason LazarJason Lazar More articles by this author , Donald BliwiseDonald Bliwise More articles by this author , Johan Vande WalleJohan Vande Walle More articles by this author , Alan WeinAlan Wein More articles by this author , Jeffrey WeissJeffrey Weiss More articles by this author , and Karel EveraertKarel Everaert More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000816.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Nocturnal polyuria (NP) is the most common cause of nocturia. The 24-hour voiding diary is a gold standard in the diagnosis of NP, but patient adherence to voiding diaries is a pervasive obstacle. This study determines the diagnostic utility of the volume and osmolality (Uosm) of a single early nocturnal urine sample in detecting NP. METHODS: Analysis of early morning urine samples obtained from 2 prospective observational studies involving subjects recruited from a urology ambulatory care unit and subjects who consulted a continence clinic. For both protocols (n=230), participants completed 24-72-h voiding diaries, and then subsequently collected urine samples at fixed 3-h intervals (Q3H) for 24 hours. Nocturic subjects (≥1 nocturnal void[s] on voiding diary) (n=176) were included for analysis. Included subjects were stratified based on the presence (n=87) or absence (n=89) of NP (nocturnal urine volume >90 mL/h) on the day of Q3H urine collection. Receiver operating characteristic curves with Youden’s Index were used to determine optimal cutoff values for 1am volume and Uosm by NP status. RESULTS: Participants with vs. without NP demonstrated a higher 1am volume (400 [300-515 IQR] vs. 200 [160-300] mL, AUC=0.843, p<0.001, Optimal Cutoff=350 mL) and lower Uosm (274 [201-348] vs. 430 [320-664] mOsm/kg H2O, AUC=0.774, p<0.001, Optimal Cutoff=314 mOsm/kg H2O) (Figure 1). Combined, criteria of either 1am volume ≥350 mL or Uosm ≤314 mOsm/kg H2O resulted in an 85% sensitivity and 75% specificity for NP, while criteria of both 1am volume ≥350 mL and Uosm ≤314 mOsm/kg H2O resulted in a 60% sensitivity and 92% specificity for NP. For men, combining the optimal cutoffs resulted in an “either/or” sensitivity of 80% and specificity of 79%, and a “both/and” sensitivity of 60% and specificity of 96% for NP. For women, combining the optimal cutoffs resulted in an “either/or” sensitivity of 90% and specificity of 68%, and a “both/and” sensitivity of 65% and specificity of 89% for NP. CONCLUSIONS: Nocturic patients with NP are more likely than those without NP to produce a higher volume of more dilute urine in the early hours of sleep. Analysis of easily measurable parameters of the first nocturnal void (for which 1am values serve as a surrogate) can predict a diagnosis of NP with a high degree of sensitivity and specificity. Source of Funding: NA © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e11-e12 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Thomas Monaghan* More articles by this author Joseph Verbalis More articles by this author Rebecca Haddad More articles by this author Kim Pauwaert More articles by this author Christina Agudelo More articles by this author An-Sofie Goessaert More articles by this author Denys Marie-Astrid More articles by this author Jason Lazar More articles by this author Donald Bliwise More articles by this author Johan Vande Walle More articles by this author Alan Wein More articles by this author Jeffrey Weiss More articles by this author Karel Everaert More articles by this author Expand All Advertisement PDF downloadLoading ...