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Nocturia
Aka: Nocturia, Nocturnal Frequency
- See Also
- Urinary Frequency
- Polyuria
- Definitions
- Nocturia
- Frequent Urination at night (more than once)
- Mechanism
- Urine Volumes are typically reduced at night via diurnal rhythm
- Nocturia occurs when urine formed exceeds Bladder capacity
- Decreased Bladder capacity
- Decreased renal concentrating function
- High Sodium excretion or other solute diuresis
- Causes
- All causes of Polyuria also cause Nocturia
- Diabetes Mellitus
- Diabetes Insipidus
- Primary Polydipsia (e.g. water Intoxication)
- Decreased Bladder capacity (may be due to inflammation or irritability)
- Urinary Tract Infection
- Bladder Tumor
- Urinary tract stone
- Edematous State fluid redistributes at night into dependent positions and then intravascularly mobilized
- Congestive Heart Failure
- Nephrotic Syndrome
- Hepatic Cirrhosis with Ascites
- Venous Insufficiency
- Bladder outflow obstruction
- Benign Prostatic Hyperplasia
- Urethral Stricture
- Urinary tract stone
- Pelvic tumor
- Other causes
- Sleep Apnea
- Management
- Identify and treat underlying causes
- Benign Prostatic Hyperplasia
- Diabetes Mellitus
- Diabetes Insipidus
- Overactive Bladder
- Obstructive Sleep Apnea
- Employ simple strategies
- Dose Loop Diuretics earlier in the day
- Redistribute edema during the daytime (e.g. Compression Socks, leg elevation)
- Medications (not recommended)
- Low dose Desmopressin (Noctiva)
- Expensive, marginal efficacy, risk of Hyponatremia (requires Sodium monitoring)
- References
- (2018) Presc Lett 25(5): 27
- Coe in Wilson (1991) Harrison's Internal Medicine, 12th ed, McGraw Hill, p. 275