The Risk of Hyponatremia with Desmopressin Use for Nocturnal Polyuria

Title
The Risk of Hyponatremia with Desmopressin Use for Nocturnal Polyuria
Author
박준성
Keywords
Hyponatremia; Desmopressin; Elderly; Hemoglobin
Issue Date
2015-04
Publisher
KARGER
Citation
AMERICAN JOURNAL OF NEPHROLOGY, v. 41, NO 3, Page. 183-190
Abstract
Background: Desmopressin is used for treating nocturnal polyuria, but hyponatremia is an associated concern in the elderly due to impaired urinary dilution. This study was undertaken to characterize hyponatremia occurring in adults using desmopressin for nocturnal polyuria. Methods: Data from 172 patients who were prescribed desmopressin for nocturnal polyuria at a urology clinic from September 2010 through February 2013 were retrospectively analyzed. Demographic and laboratory parameters were investigated to examine the risk factors for desmopressin-associated hyponatremia. Results: The average follow-up serum sodium measured 21 +/- 22 days after using desmopressin was 138 +/- 5 mmol/l. Hyponatremia (<135 mmol/l) was found in 24 patients (14%), and it was severe in 7 (<126 mmol/l). In the hyponatremic patients, serum sodium decreased by 11 +/- 6 mmol/l. Patients with hyponatremia were older than those with normonatremia (78 +/- 7 vs. 68 +/- 9 years, p < 0.0001). The presence of either hyponatremia-predisposing comorbidities or concurrent medications was associated with hyponatremia. Patients with hyponatremia had lower basal hemoglobin (11 +/- 2 vs. 13 +/- 2 g/dl, p < 0.001) and serum sodium (139 +/- 2 vs. 140 +/- 2 mmol/l, p < 0.05) than those with normonatremia. Multivariate logistic regression after adjustment for basal serum sodium showed that advanced age (OR 1.15; 95% CI 1.03-1.27) and lower hemoglobin level (OR 0.64; 95% CI 0.43-0.94) were independently associated with hyponatremia. Conclusion: Hyponatremia is not infrequently associated with desmopressin use. Those with advanced age (>= 65 years) and lower hemoglobin are at risk of desmopressin-associated hyponatremia and need to be carefully monitored. (C) 2015 S. Karger AG, Basel
URI
http://www.karger.com/Article/Abstract/381562http://hdl.handle.net/20.500.11754/23961
ISSN
0250-8095; 1421-9670
DOI
10.1159/000381562
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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