Abstract
Rationale:Nocturnal enuresis is a common symptom of nephrogenic diabetes insipidus (NDI) in children. Published reports on the treatment of nocturnal enuresis in this population are scarce. Presenting concern of the patient: 2 brothers, aged 8 and 9 years, presented for outpatient pediatric nephrology follow-up. Despite being medically stable on their current medication regimen, they both experienced significant distress due to primary nocturnal enuresis, including decreased self-esteem and social stress.Diagnoses:The brothers had primary nocturnal enuresis related to their high urine output from NDI. Interventions: we describe a case of 2 brothers with NDI in whom indomethacin was added to their pharmacologic treatment specifically to address enuresis.Outcome:Both brothers experienced a significant decrease in the frequency of nocturnal enuresis and improvement in their perceived quality of life.Teaching points:Nocturnal enuresis is a bothersome symptom of NDI with adverse psychological effects. Indomethacin can improve nocturnal enuresis in some patients. Treatment with nonsteroidal anti-inflammatory drugs carries a risk of gastrointestinal and kidney side effects. We advocate for a patient-centered approach to the treatment of NDI which includes optimizing both the medical and the psychological needs of the patient.
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