Monocentric single-arm study of desmopressin acetate efficacy on nocturnal polyuria in the elderly.

AIM OF THE STUDY: we designed a retrospective, monocentric, observational study to assess the short-term side effect profile of desmopressin, a synthetic analogue of antidiuretic hormone, in 42 elderly patients affected by nocturnal polyuria (NP), a subset of nocturia (nocturnal overproduction of urine at night), which is characterised by nocturnal urine volume (NVU) exceeding 33% of the 24-h total urine output. METHODS USED TO CONDUCT THE STUDY: the subjects had NP and included 25 males, which had BPH bladder instability (12 out of 25 had been surgically or endoscopically operated) and 15 females that had urinary symptoms. Patients recorded the number of voids during waking hours using a digital continuous urine meter. The quality of life (QoL) and efficacy of desmopressin were assessed at baseline and 12 weeks after treatment using the International Consultation on Incontinence Questionnaire Nocturia Quality of Life Module (ICIQ-Nqol) and IPSS-QoL questions (IPPS-Q8). The dosage of desmopressin acetate varied according to the discretion of the physician, usually beginning with one tablet before going to bed at night for three months. The dose was increased at 1-week intervals if a reduction in the NVU or night-time frequency was not achieved. RESULTS OF THE STUDY: we found that desmopressin treatment reduced the nocturnal voided volume (p<0.0001), ICIQ-Nqol (p<0.0001) and IPPS-Q8 (p<0.0001). No significant serum sodium alterations or modifications in serum creatine, potassium, or body weight were observed in all the patients. No adverse effects were observed. CONCLUSIONS DRAWN FROM THE STUDY AND CLINICAL IMPLICATIONS: our findings show efficacy of desmopressin in the elderly for NP treatment supporting further clinical trials in larger cohorts of patients.