High daily salt intake had a negative impact on how well nocturnal enuresis treatment worked on children aged 7-10 years

Acta Paediatr. 2020 Jan;109(1):193-197. doi: 10.1111/apa.14922. Epub 2019 Jul 17.

Abstract

Aim: We investigated whether the daily salt intake of children with nocturnal enuresis influenced their response to 1-desamino-8-D-arginine vasopressin therapy.

Methods: This study comprised 129 children (67.4% boys) with a median age of 9.2 years (range 7.2-10.4) with monosymptomatic nocturnal enuresis who were seen at Kansai Medical University Hospital, Osaka, Japan, from 2013 to 2017. Urinary sodium concentrations were determined using a spot urine test, and the children were divided into appropriate (n = 55) and excessive salt intake (n = 74) groups based on Japanese Government guidelines. After a month of therapy, the treatment responses were compared for 39 and 50 children, respectively.

Results: There were no significant differences in the urea nitrogen-to-creatinine or calcium-to-creatinine ratios in the two groups. However, the excessive salt intake group showed a significantly reduced treatment response to the appropriate salt intake group. In addition, the excessive and appropriate salt intake groups showed median efficacy ratios of 8.2% and 21.8%, respectively, based on intention-to-treat analysis (P = 0.029) and 12.0% and 30.8% based on per-protocol analysis (P = 0.029).

Conclusion: High daily salt intake significantly reduced the efficacy of ddavp therapy for nocturnal enuresis and consumption should be controlled during treatment.

Keywords: antidiuretic hormone; daily salt intake; desmopressin; nocturnal enuresis; spot urine sample.

Publication types

  • Comparative Study

MeSH terms

  • Antidiuretic Agents / therapeutic use*
  • Child
  • Deamino Arginine Vasopressin / therapeutic use*
  • Female
  • Humans
  • Male
  • Nocturnal Enuresis / drug therapy*
  • Nocturnal Enuresis / urine
  • Sodium Chloride, Dietary / urine*
  • Treatment Outcome

Substances

  • Antidiuretic Agents
  • Sodium Chloride, Dietary
  • Deamino Arginine Vasopressin