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Pediatr Nephrol. 2016 Sep;31(9):1477-84. doi: 10.1007/s00467-016-3351-3. Epub 2016 Apr 11.

Desmopressin (melt) therapy in children with monosymptomatic nocturnal enuresis and nocturnal polyuria results in improved neuropsychological functioning and sleep.

Author information

1
Department of Pediatric Nephrology/Urology and Safepedrug, University Hospital Ghent and Ghent University, De Pintelaan 185, 9000, Ghent, Belgium. charlotte.vanherzeele@ugent.be.
2
Child Neurology & Metabolism, Pediatric Sleep Center, University Hospital Ghent, Ghent, Belgium.
3
Department of Data Analysis, University Ghent, Ghent, Belgium.
4
Department of Pediatric Nephrology/Urology and Safepedrug, University Hospital Ghent and Ghent University, De Pintelaan 185, 9000, Ghent, Belgium.

Abstract

BACKGROUND:

There is a high comorbidity between nocturnal enuresis, sleep disorders and psychological problems. The aim of this study was to investigate whether a decrease in nocturnal diuresis volume not only improves enuresis but also ameliorates disrupted sleep and (neuro)psychological dysfunction, the major comorbidities of this disorder.

METHODS:

In this open-label, prospective phase IV study, 30 children with monosymptomatic nocturnal enuresis (MNE) underwent standardized video-polysomnographic testing and multi-informant (neuro)psychological testing at baseline and 6 months after the start of desmopressin treatment in the University Hospital Ghent, Belgium. Primary endpoints were the effect on sleep and (neuro)psychological functioning. The secondary endpoint was the change in the first undisturbed sleep period or the time to the first void.

RESULTS:

Thirty children aged between 6 and 16 (mean 10.43, standard deviation 3.08) years completed the study. The results demonstrated a significant decrease in periodic limb movements during sleep (PLMS) and a prolonged first undisturbed sleep period. Additionally, (neuro)psychological functioning was improved on several domains.

CONCLUSIONS:

The study demonstrates that the degree of comorbidity symptoms is at least aggravated by enuresis (and/or high nocturnal diuresis rate) since sleep and (neuro)psychological functioning were significantly ameliorated by treatment of enuresis. These results indicate that enuresis is not such a benign condition as has previously been assumed.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01645475.

KEYWORDS:

Children; Desmopressin; Periodic limb movements; Psychology; Quality of life

PMID:
27067081
DOI:
10.1007/s00467-016-3351-3
[Indexed for MEDLINE]

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