A Pharmacodynamic Study of Desmopressin in Patients with Nocturnal Enuresis
The pharmacokinetics of desmopressin (1-desamino-8-D-arginine vasopressin) were investigated in 8 patients with nocturnal enuresis, of whom 4 were known to respond completely to desmopressin and 4 were nonresponders. A decrease in urine production was confirmed in responders after the administration of desmopressin while the drug did not cause antidiuresis in nonresponders. Absorption and excretion of desmopressin were identical in each group. Results indicate at least 2 pathophysiological mechanisms in nocturnal enuresis, including insufficient nocturnal production of arginine vasopressin and impaired renal sensitivity to arginine vasopressin and desmopressin. Each type results in high nocturnal urine production.
References
- 1 : Diurnal antidiuretic hormone levels in enuretics. J. Urol.1985; 134: 1029. Link, Google Scholar
- 2 : Abnormal diurnal rhythm of plasma vasopressin and urinary output in patients with enuresis. Amer. J. Physiol.1989; 25: F664. Google Scholar
- 3 : Ar den natlige vasopressin insondring mindskad vid enures?. Proc. Swed. Acad. Phys.1986; : 251. Google Scholar
- 4 : Urinary levels of antidiuretic hormone in nocturnal enuresis. Ind. Ped.1980; 17: 675. Google Scholar
- 5 : Nocturnal enuresis: an approach to treatment based on pathogenesis. J. Ped.1989; 114: 705. part 2. Google Scholar
- 6 : Desamino-8-D-arginine vasopressin (DDAVP): pharmacology and clinical use. Drugs Today1988; 24: 509. Google Scholar
- 7 : Plasma kinetics of DDAVP in man. Acta Pharmacol. Toxicol.1986; 58: 379. Google Scholar
- 8 :
Long-term double-blind cross-over study of desmopressin intranasal spray in the management of nocturnal enuresis . In: Desmopressin in Nocturnal Enuresis. Edited by . : Horus Medical Publication1989: 43. Google Scholar - 9 : Desmopressin in nocturnal enuresis. J. Urol.1991; 145: 818. Link, Google Scholar
- 10 : Use of three specific radioimmunoassays in measuring neurohypophysical hormone content and plasma concentrations of vasopressin, oxytocin and DDAVP in rats after prolonged infusion of DDAVP. Experientia1985; 41: 933. Google Scholar
- 11 : Evidence for bladder motor inhibition by desmopressin via central transmitter mechanisms. Neurourol. Urodynam.1990; 9: 449. Google Scholar
- 12 : Urodynamics in enuretics. Reservoir function. Neurourol. Urodynam.1989; 8: 199. Google Scholar
- 13 : Urodynamics in enuretics. A pressure flow study. Neurourol. Urodynam.1989; 8: 213. Google Scholar
Urological Department K, Aarhus University Hospital, Skejby Section and Institute of Experimental Clinical Research, University of Aarhus, Aarhus, Denmark
