Defect of Osmoregulatory Renal Function in Nocturnal Enuresis

Abstract

Renal function was studied in 62 children with primary nocturnal enuresis (PNE) and in 20 healthy children aged 6-15 years. During the night, children with PNE exhibited an increase in diuresis, free water reabsorption and solute excretion (including sodium and magnesium) in comparison to controls. Intranasal administration of Adiuretin-SD® (10.5-24.5 &#55 g) in the evening reduced diuresis and ion excretion to normal levels. During the treatment, 61% of the children became completely dry and, in 24% of the children, the number of wet nights was reduced by 50%. It is suggested that in the pathogenesis of PNE, the decrease in ion reabsorption in the thick ascending Henle's loop-resulting in a greater load of tubular fluid in the collecting ducts, an elevation of diuresis and increases in free water reabsorption and solute excretion-plays the leading role in disturbing renal function. Treatment of PNE with desmopressin is pathogenically justified, as it eliminates the principal defect of renal tubular function.