Non-dipping phenomenon in children with monosymptomatic nocturnal enuresis
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ORIGINAL ARTICLE
Non-dipping phenomenon in children with monosymptomatic nocturnal enuresis Aydin Kahraman & Hasan Dursun & Sami Hatipoglu & Bahar Kural & Mustafa Sahin & Korhan Birgul & Mehmet Bedir Akyol
Received: 21 October 2012 / Revised: 15 February 2013 / Accepted: 18 February 2013 / Published online: 20 March 2013 # The Author(s) 2013. This article is published with open access at Springerlink.com
Abstract Purpose Monosymptomatic nocturnal enuresis is a common disorder seen in childhood, and many factors play a role in its etiopathology to varying degrees. The aim of our study was to investigate the possible association between nocturnal enuresis and 24-h blood pressure profiles of enuretic children. Methods A total of 45 children ranging in age from 6 to 15 years with monosymptomatic nocturnal enuresis and 22 age-matched healthy controls were enrolled in our study. The blood pressure measurement was made at 30-min intervals during a 24-h period via an ambulatory blood pressure measurement device. Both groups underwent medical tests that included a complete blood count, blood biochemistry profile, urinalysis and blood renin–aldosterone levels, and all study subjects received an abdominal ultrasound. Results Statistically significant high nocturnal blood pressure levels were observed in our patients with monosymptomatic nocturnal enuresis compared with the control group (p0.05). However, the nocturnal mean SBP and DBP values of patients were significantly higher than those of the controls (p0.05). The differences between daytime and nocturnal mean SBP (systolic dipping), DBP (diastolic dipping) and MAP (mean dipping) values were evaluated. The mean values of systolic dipping and diastolic dipping of patients were significantly lower than those of control group (p = 0.047 and p = 0.001, respectively). However, no significant difference was observed between the mean values of mean dipping (p>0.05). The day-to-night change (difference) in SBP values (expressed in percentage) based on a change of “< 10%” was found to be significantly higher in patients than controls [37 (82.2 %) vs. 13 (59.10 %), respectively; p0.05). No statistically significant correlation was found between the levels of spot urine creatinine and mean DBP and MAP values (p>0.05); however, we did find a statistically significantly negative correlation between spot urine creatinine and SBP (r = 0.409, p = 0,012). In addition, we observed a positive correlation between serum sodium levels (138.33±2.65) and SBP (r = 0.308 p = 0.039), DBP (r = 0.321 p = 0.032) and MAP (r = 0.311, p = 0.038) values. No significant correlation was observed between urine density and SBP (p>0.05); however we found a statistically significant negative correlation between urine density and DBP and MAP values (r = −0.338, p = 0.023 and r = −0.325, p = 0.029, respectively).
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our patient group in which there was an overrepresentation of the male gender among enuretic children. Normally, the nocturnal decrease in urine production is accompanied by decreased BP during
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