夜間多尿症的高齡病患服用去氨加壓素治療導致低血鈉症之危險因子
瞿琤、林志杰
台北榮民總醫院 泌尿部
The risk factors of hyponatremia in the desmopressin replacement of elderly patients with nocturnal polyuria
Cheng Chu, Chih-Chieh Lin
Department of Urology, Taipei Veteran General Hospital, Taiwan
Purpose: In lacking of research in the potential risk factors of hyponatremia after desmopressin replacement in the elderly patients with nocturnal polyuria, we herein investigate the risk factors and the incidence of hyponatremia after treatment.
Materials and Methods: From January in 2018 to February in 2019 in our institute, those patients who meet the criteria of nocturnal polyuria were recruited in this retrospective study. All patients recorded 24 hours voiding diaries for 3 days and worked out mean number of nocturnal voids. Nocturnal polyuria index was counted and the cut-off value was set at 0.33. Desmopressin 0.1 mg was given orally to all patients before going to bed at night for 3 months. Before treatment and monthly after treatment, mean number of nocturnal voids, adverse events were recorded. Before treatment and both 1month, 2 months and 3 months after treatment, the patients in treatment group had to be checked blood serum sodium.
Results: A total of 29 patients, who greater than 65 years of age, male 26 and female 3, were enrolled in this retrospective study. Mean number of nocturia before and after receiving Minirin were 3.62 and 1.8 respectively (P value 0.018). No serious events occurred and no adverse events of severe intensity were recorded. After 1st month, the change from baseline serum sodium was – 2.955 mmol/L (P value 0.003). Following in 2nd and 3rd month, then change from baseline serum sodium were -2.646 mmol/L (P value 0.008) and-1.312 mmol/L (P value 0.189) respectively. Eight patients qualified as being sensitive t/o change in serum sodium. The risk of hyponatremia was increased with age and using lipid-modifying drugs.
Conclusions: During the study, 8 patients (27%) reports hyponatremia from 118 to 134 mmol/L. They also complained mild nausea (2/8), headlightness (1/8) and abdominal pain (1/8). Low-dose Minirin is an effective and well-tolerated treatment for nocturia in elderly patient.