TY - JOUR
T1 - Oral ddAVP for nighttime urinary incontinence in characterized nursing home residents
T2 - A pilot study
AU - Johnson, Theodore M.
AU - Miller, Myron
AU - Tang, Terence
AU - Pillion, Dennis J.
AU - Ouslander, Joseph G.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2006/1
Y1 - 2006/1
N2 - Objectives: To (1) identify abnormalities in arginine vasopressin (AVP, a water-conserving hormone) secretion and release in nursing home (NH) residents with nighttime urinary incontinence (UI); and (2) perform a pilot test of desmopressin acetate (ddAVP, a synthetic analog of the naturally occurring hormone) replacement in these residents. Design: Diagnostic evaluation and open-label treatment trial. Setting: Two community nursing homes in a metropolitan area. Participants Male and female NH residents 65 years of age and older with nighttime UI. Intervention: Characterizations of AVP status followed by a 7-day open-label trial of oral ddAVP (either 0.1 mg or 0.2 mg). Measurements: Water deprivation test results, AVP levels, voided volumes, number of voids, incontinent episodes, number of nighttime checks found wet (out of 6 total checks per night). Results: All participants had measurable AVP levels of 2.0 pg/mL or higher. Six of 10 individuals had an abnormal water deprivation test. Two of 4 participants on 0.2 mg of ddAVP and 2 of 6 participants on 0.1 mg had a 200 mL or more mean reduction in nighttime urine volume. Both ddAVP dosages yielded a mean reduction of 0.7 fewer nighttime wet checks found wet. One participant in each group developed hyponatremia (1 of 6 on 0.1 mg and 1 of 4 on 0.2 mg). Hyponatremia resolved with discontinuation of the drug. Conclusion: Both 0.1 mg and 0.2 mg of ddAV P given to carefully screened NH residents for 7 days produced a modest average reduction in nighttime urine volume and number of nighttime incontinent episodes that is likely of little clinical importance. The role of ddAVP in this population requires further research.
AB - Objectives: To (1) identify abnormalities in arginine vasopressin (AVP, a water-conserving hormone) secretion and release in nursing home (NH) residents with nighttime urinary incontinence (UI); and (2) perform a pilot test of desmopressin acetate (ddAVP, a synthetic analog of the naturally occurring hormone) replacement in these residents. Design: Diagnostic evaluation and open-label treatment trial. Setting: Two community nursing homes in a metropolitan area. Participants Male and female NH residents 65 years of age and older with nighttime UI. Intervention: Characterizations of AVP status followed by a 7-day open-label trial of oral ddAVP (either 0.1 mg or 0.2 mg). Measurements: Water deprivation test results, AVP levels, voided volumes, number of voids, incontinent episodes, number of nighttime checks found wet (out of 6 total checks per night). Results: All participants had measurable AVP levels of 2.0 pg/mL or higher. Six of 10 individuals had an abnormal water deprivation test. Two of 4 participants on 0.2 mg of ddAVP and 2 of 6 participants on 0.1 mg had a 200 mL or more mean reduction in nighttime urine volume. Both ddAVP dosages yielded a mean reduction of 0.7 fewer nighttime wet checks found wet. One participant in each group developed hyponatremia (1 of 6 on 0.1 mg and 1 of 4 on 0.2 mg). Hyponatremia resolved with discontinuation of the drug. Conclusion: Both 0.1 mg and 0.2 mg of ddAV P given to carefully screened NH residents for 7 days produced a modest average reduction in nighttime urine volume and number of nighttime incontinent episodes that is likely of little clinical importance. The role of ddAVP in this population requires further research.
KW - Desmopressin
KW - Nighttime UI
KW - Nursing home
KW - Urinary incontinence
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U2 - 10.1016/j.jamda.2005.04.010
DO - 10.1016/j.jamda.2005.04.010
M3 - Article
C2 - 16413428
AN - SCOPUS:32444451581
SN - 1525-8610
VL - 7
SP - 6
EP - 11
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 1
ER -