The pathophysiology of monosymptomatic nocturnal enuresis with special emphasis on the circadian rhythm of renal physiology.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing pathophysiological mechanisms without systematic search or meta-analytic methodology.
PubMed 27138767 · doi:10.1007/s00431-016-2729-3
What was done
The authors conducted a PubMed search to assemble a concise review focusing on renal aspects and circadian rhythms in the pathophysiology of nocturnal polyuria among children with monosymptomatic nocturnal enuresis (MNE).
What was found
The abstract reports that 20% to 60% of children with monosymptomatic nocturnal enuresis are resistant to desmopressin therapy. Nocturnal polyuria is partially explained by a blunted circadian rhythm of vasopressin secretion, but alterations in the intrinsic renal circadian clock system also appear to contribute, particularly in desmopressin-resistant cases. No other numerical data were reported.
Why it matters
This review highlights that renal circadian clock dysfunction beyond simple vasopressin deficiency contributes to nocturnal polyuria, providing a mechanistic rationale for why many children do not respond to desmopressin.
Limits
The paper is a narrative review without systematic search protocols, quality appraisal, or meta-analytic pooling. The abstract does not specify the number of included studies, sample sizes, or quantitative effect estimates.
Cited by
- supports Bedwetting and nighttime urination problems in young children occur because the hormone vasopressin has not fully developed yet.