Could Evening Dietary Protein Intake Play a Role in Nocturnal Polyuria?

Urea is the most abundant and the largest contributing factor for urine osmolality. Urinary urea excretion is highly interrelated with dietary protein intake. Accordingly, an increase of urinary urea excretion due to high protein diet may lead to urea-induced osmotic diuresis. This study aims to explore the association between nocturnal polyuria (NP) and urea. This is a post hoc analysis of a prospective observational study of subjects who completed a renal function profile between October 2011 and February 2015 (n = 170). Each subject underwent a 24 h urine collection, which included 8 urine samples collected at 3 h intervals. Urine volume, osmolality, creatinine, urea and sodium were determined. Urinary urea excretion was used to estimate dietary protein intake. Compared to the control group, subjects with NP exhibited significantly higher nighttime urea and sodium excretion. Estimated evening dietary protein intake was correspondingly significantly higher amongst the NP subgroup. Nighttime diuresis rate was positively associated with age and nighttime free water clearance, creatinine clearance, sodium excretion, and urea excretion in NP subjects. Therefore, increased nocturnal urinary urea excretion may reflect an additional important mediator of nocturia owing to excess nocturnal urine production.

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Clinical efficiency of desmopressin and cyclooxygenase inhibitor use in incontinent women

Journal of obstetrics and women s diseases ◽

10.17816/jowd67240-51 ◽

2018 ◽

Vol 67 (2) ◽

pp. 40-51

Author(s):

Natalya A. Osipova ◽

Dariko A. Niauri ◽

Alexander M. Gzgzyan

Keyword(s):

Circadian Rhythm ◽

Comparison Group ◽

Urine Volume ◽

Control Group ◽

Thick Ascending Limb ◽

Nocturnal Polyuria ◽

Initial State ◽

Urine Incontinence ◽

Clinical Efficiency ◽

Urine Production

Hypothesis/aims of study. Questions regarding the pathogenesis of urine incontinence and methods of treatment are acti vely discussed by gynecologists, urologists, and neuropathologists. Urine incontinence often has multifactor origins: the causes of urine incontinence are connected, as a rule, with the violation of urine continence functional mechanisms, anatomotopographical features of the lower urinary tract, or an premature ovarian failure. Simultaneously, changes in kidney function play a role in the pathogenesis of urine incontinence. In some cases, urine incontinence is combined with urine overproduction or inversion of the circadian rhythm of renal function owing to a decrease in the reabsorption of sodium ions in the thick ascending limb of the loop of Henle. In some patients, we successfully normalized ion transport, diuresis, and circadian rhythm of urine production by desmopressin or diclofenac administration. The present analysis was undertaken to evaluate the clinical efficiency of desmopressin and diclofenac in incontinent patients with nocturnal polyuria and polyuria. Study design, materials, and methods. In total, 130 patients with complaints of urinary incontinence, polyuria (24-h urine volume of 40 mL/kg bodyweight or above), or nocturnal polyuria (nocturnal volume/24-h urine volume of 0.33 or above); 30 incontinent women without polyuria or nocturnal polyuria (comparison group); and 14 control subjects were included. The mean patient age was 43.6 ± 4.5 years (41.8 ± 3.7 years in the comparison group and 39.4 ± 6.3 years in the control group, p > 0.05). All the participants performed seven days of urine collection to determine the voided volumes. Patients with polyuria or nocturnal polyuria performed the 3-fold 24-h pad-test. Patients with polyuria and nocturnal polyuria were examined twice: in the initial state and one month after the start of treatment with the optimal dose of diclofenac or desmopressin (Minirin). Results. The use of both diclofenac or desmopressin in patients with various types of urine incontinence, polyuria, or nocturia decreased the volume of voided urine because of the normalization of diuresis and an increase in cystometric bladder capacity.

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Efficacy of Restricting Dietary Protein Intake Combined with Buyang Huanwu Decoction in Treating Diabetic Nephropathy and Its Effect on Patients’ Inflammatory Factor Levels

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/5906244 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Dan Chen ◽

Dan Huang ◽

Taotao Hu ◽

Fang Chen

Keyword(s):

Renal Function ◽

Dietary Protein ◽

Protein Intake ◽

Effective Rate ◽

Control Group ◽

Inflammatory Factor ◽

Dietary Protein Intake ◽

Buyang Huanwu Decoction ◽

Experimental Group ◽

Better Than

Objective. To study the efficacy of restricting dietary protein intake combined with Buyang Huanwu decoction in treating diabetic nephropathy (DN) and its effect on patients’ inflammatory factor levels. Methods. The medical data of 150 DN patients treated in Wuhan No.1 Hospital (June 2018—May 2021) were retrospectively analyzed. All patients received regular therapy, those who received the intervention of restricting dietary protein intake were included in the control group (n = 75), and on this basis, those treated with Buyang Huanwu decoction were included in the experimental group (n = 75), so as to scientifically evaluate their efficacy and inflammatory factor levels after treatment. Results. The patients’ general information was not statistically different between the two groups ( P > 0.05 ); after treatment, the experimental group gained remarkably higher marked effective rate and total effective rate of treatment than the control group ( P < 0.05 ); the inflammatory factor levels of all patients were obviously better than before ( P < 0.05 ), and the levels of TNF-α, IL-2, IL-8, IL-4, and IL-10 were obviously lower in the experimental group than in the control group ( P < 0.05 ); the levels of fasting blood glucose, 2 h postprandial blood glucose, and glycosylated hemoglobin of all patients were remarkably lower than before ( P < 0.05 ), but with no significant between-group difference ( P > 0.05 ); the renal function indexes of all patients were better than before, and between the two groups, the levels of 24 h microalbuminuria, 24 h urine protein excretion, and serum creatinine were obviously lower and the glomerular filtration rate was significantly higher in the experimental group ( P all <0.05), and the patients’ traditional Chinese medicine (TCM) symptom scores were remarkably lower in the experimental group ( P < 0.05 ). Conclusion. Jointly applying Buyang Huanwu decoction on the basis of restricting dietary protein intake can effectively promote the clinical efficacy of DN, which is conducive to adjusting the inflammatory factor levels, promoting the patients’ renal function, and alleviating the clinical symptoms.

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