Monaghan Thomas F, Rahman Syed N, Bliwise Donald L, Michelson Kyle P, Agudelo Christina W, Miller Connelly D, Weinstein Corey S, Olesen Tine K, Lazar Jason M, Everaert Karel, Verbalis Joseph G, Weiss Jeffrey P
Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York.
Department of Neurology, Emory University School of Medicine, Atlanta, Georgia.
Neurourol Urodyn. 2020 Jan;39(1):347-352. doi: 10.1002/nau.24210. Epub 2019 Nov 6.
Nocturnal polyuria (NP) and global polyuria (GP) are not mutually exclusive. However, by rate, the common criteria for GP (40 mL/kg/24 hours [117 mL/kg/hour in a 70-kg individual] or 3000 mL/24 hours [125 mL/h]) are more stringent than those for NP (90 mL/hour during the sleep period or NP index [NPi; nocturnal volume/24-hour volume] > 0.33 [no minimum rate]). It remains unclear whether total nocturnal urine volume (NUV) may reliably delineate between NP patients with and without comorbid GP.
A clinical database of men with lower urinary tract symptoms was searched for voiding diaries completed by patients reporting greater than or equal to 1 nocturnal void(s). Four separate analyses were performed using all combinations of the two NP and two GP criteria listed above. For each analysis, patients were included if they met the criteria for NP, and then stratified by presence or absence of GP (ie, NP + GP vs isolated NP).
Median NUV was greater among patients with NP + GP for all criteria combinations. Sensitivities greater than or equal to 80%/90%/100% for NP + GP were observed at 1275/1230/1085 mL for {NPi > 0.33 + 24-hour volume > 3000 mL}; 1075/1035/1035 mL for {NPi > 0.33 + 24-hour volume > 40 mL/kg}; 900/745/630 mL for {NUP > 90 mL/hour + 24-hour volume > 3000 mL}; and 1074/1035/990 mL for {NUP > 90 mL/hour + 24-hour volume > 40 mL/kg}.
An inordinate NUV among men with NP is fairly sensitive for comorbid GP. In the appropriate clinical setting, nocturnal-only diaries may suffice in the evaluation and follow-up of patients with NP, so long as outlying nocturnal volumes prompt a 24-hour diary/urine collection.
夜间多尿（NP）和总体多尿（GP）并非相互排斥。然而，就尿量而言，GP的常用标准（40毫升/千克/24小时[70千克个体为117毫升/千克/小时]或3000毫升/24小时[125毫升/小时]）比NP的标准（睡眠期间90毫升/小时或NP指数[NPi；夜间尿量/24小时尿量]＞0.33[无最小尿量]）更为严格。目前尚不清楚夜间总尿量（NUV）是否能可靠地区分合并或未合并GP的NP患者。
在一个有下尿路症状男性的临床数据库中搜索排尿日记，这些日记由报告有≥1次夜间排尿的患者填写。使用上述两种NP和两种GP标准的所有组合进行四项独立分析。对于每项分析，符合NP标准的患者被纳入，然后根据是否存在GP进行分层（即NP+GP与孤立性NP）。
对于所有标准组合，NP+GP患者的NUV中位数更高。对于NP+GP，在以下标准下观察到敏感性≥80%/90%/100%：对于{NPi＞0.33+24小时尿量＞3000毫升}为1275/1230/1085毫升；对于{NPi＞0.33+24小时尿量＞40毫升/千克}为1075/1035/1035毫升；对于{NUP＞90毫升/小时+24小时尿量＞3000毫升}为900/745/630毫升；对于{NUP＞90毫升/小时+24小时尿量＞40毫升/千克}为1074/1035/990毫升。
NP男性中异常的NUV对合并GP相当敏感。在适当的临床环境中，只要异常的夜间尿量促使进行24小时日记/尿液收集，仅夜间日记可能足以用于NP患者的评估和随访。
