Pauwaert Kim, Bruneel Elke, Van Laecke Erik, Depypere Herman, Everaert Karel, Goessaert An-Sofie
Department of Urology, Ghent University Hospital, Belgium.
Department of Urology, Ghent University Hospital, Belgium.
Maturitas. 2022 Jun;160:61-67. doi: 10.1016/j.maturitas.2022.01.009. Epub 2022 Jan 29.
To observe the impact of hormonal treatment (HT) on voiding patterns and renal circadian rhythms in postmenopausal women with and without nocturnal polyuria (NP).
A prospective, observational study was executed at the menopause clinic of a tertiary hospital. HT was based on patients' choice and was in the form of either oral and transdermal oestrogen. Participants completed a 72-hour bladder diary, completed the ICIQ-FLUTS questionnaire, recorded a renal function profile and gave a blood sample. This set of tests was done before and after 3 months of HT.
32 postmenopausal women with a median age of 52.5 (49.3-56.0) years were enroled in this study. Three months of HT resulted in a significant decrease in fluid intake (p < 0.001) and daytime voiding frequency (p = 0.019). No impact on nocturnal parameters was observed. Observations drawn from the questionnaires did not differ between the baseline and three-month assessments. HT led to a disappearance of the circadian rhythm of the diuresis rate and sodium clearance in patients without NP, as no significant difference between daytime and night-time values was observed (diuresis rate p = 0.3; sodium clearance p = 0.08). In patients with NP at baseline, HT did not induce a circadian rhythm of the diuresis rate and sodium clearance (p = 0.2; p = 0.7). In contrast, free water clearance did change to a clear circadian rhythm (p = 0.02).
HT led to a significant reduction in both fluid intake and daytime frequency. In women without NP, HT led to a disruption of the circadian rhythms of water and salt diuresis. In patients with NP, a limited normalisation of the circadian rhythm of free water clearance was observed after three months of HT. CLINICAL TRIAL REGISTRATION NUMBER FROM CLINICALTRIALS.GOV: NCT04891926.
观察激素治疗（HT）对有和没有夜间多尿（NP）的绝经后妇女排尿模式和肾脏昼夜节律的影响。
在一家三级医院的更年期诊所进行了一项前瞻性观察研究。HT基于患者的选择，采用口服和经皮雌激素的形式。参与者完成了一份72小时膀胱日记，完成了ICIQ-FLUTS问卷，记录了肾功能概况并采集了血样。这组测试在HT治疗3个月前后进行。
32名绝经后妇女参与了本研究，中位年龄为52.5（49.3 - 56.0）岁。3个月的HT导致液体摄入量显著减少（p < 0.001）和白天排尿频率显著降低（p = 0.019）。未观察到对夜间参数的影响。问卷所得观察结果在基线和三个月评估之间无差异。HT导致无NP患者的利尿率和钠清除率昼夜节律消失，因为白天和夜间值之间未观察到显著差异（利尿率p = 0.3；钠清除率p = 0.08）。基线时有NP的患者中，HT未诱导出利尿率和钠清除率的昼夜节律（p = 0.2；p = 0.7）。相比之下，自由水清除率确实转变为明显的昼夜节律（p = 0.02）。
HT导致液体摄入量和白天排尿频率均显著降低。在无NP的女性中，HT导致水和盐利尿的昼夜节律紊乱。在有NP的患者中，HT治疗3个月后观察到自由水清除率昼夜节律有限程度的正常化。来自CLINICALTRIALS.GOV的临床试验注册号：NCT04891926。
