Nocturnal Polyuria with Abnormal Circadian Rhythm of Plasma Arginine Vasopressin in Post-stroke Patients

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概要

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• Objective Nocturia is a common reason for interrupted sleep in post-stroke patients. These patients often have neurogenic bladder overactivity. However, little is known about the possible contribution of nocturnal polyuria in the patients.Methods We measured the number of nocturia, the circadian plasma arginine vasopressin (AVP) level and urinary excretion in 4 patients with stroke.Results All patients had nocturnal urinary frequency (three times in one and twice in 3). All patients were revealed to have nocturnal polyuria, and the ratio of nocturnal urinary output to 24 hour volume ranged from 36% to 63%. Measurement of daily plasma AVP variation showed that all patients lost normal nocturnal rise of the plasma AVP concentration. Two patients were successfully treated with 5 μg of intranasal desmopressin once a night, a potent analogue of AVP, without hypertension particularly in the night, signs of congestive cardiac failure or any electrolyte abnormality such as hyponatremia.Conclusion Our post-stroke patients had nocturnal polyuria with abnormal circadian rhythm of plasma AVP secretion. Desmopressin reduced nocturnal waking in urination. It also ameliorated nocturnal dehydration that might trigger a stroke recurrence in the patients.

• 2005-04-01

著者

• YAMAMOTO Tatsuya

  Department of Chemical Engineering, Faculty of Engineering, Iwate University

• UCHIYAMA Tomoyuki

  Department of Neurology, Chiba University

• HATTORI Takamichi

  Department of Neurology, Chiba University

• Hattori Takamichi

  Department Of Neurology Chiba University

• Ito Takashi

  Department Of Chemistry School Of Science The University Of Tokyo

• Liu Zhi

  Department Of Neurology Chiba University

• Sakakibara Ryuji

  Department Of Neurology Chiba University

• Yamanishi Tomonori

  Department Of Urology Chiba University Graduate School Of Medicine

• Liu Zhi

  Department Of Chemistry Wuhan University

• Sakakibara Ryuji

  Department Of Neurology Sakura Medical Center Toho University

• Yamanishi Tomonori

  Department Of Urology Dokkyo Medical University

• Liu Zhi

  Department Of Chemical Engineering Tokyo University Of Agriculture And Technology

• Yamamoto Tatsuya

  Department Of Applied Chemistry Graduate School Of Engineering Hiroshima University

• Yamamoto Tatsuya

  Department Of Neurology Chiba University

• Uchiyama Tomoyuki

  Department Of Materials Science Shizuoka Institute Of Science And Technology

• Ito Takashi

  Department of Chemical Engineering, Graduate School of Engineering, Nagoya University

• ITO Takashi

  Department of Neurology, Chiba University

• ITO Takashi

  Department of Advanced Materials Chemistry, Graduate School of Engineering, Yokohama National University

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