Nocturnal polyuria is the excretion at night of an excessive volume of urine. A major problem following renal transplantation is an abnormal diurnal rhythmicity in urine output. The purpose of this study was to elucidate the prevalence of nocturnal polyuria among renal transplant recipients in the early period after transplantation as well as at least 1 year after transplantation. We aimed to explore possible pathophysiological mechanisms behind nocturnal polyuria in this group of patients, focusing on the impact of blood pressure and medication.
Seventeen recently transplanted patients 17 late transplant recipients, and 17 healthy controls were included in the study. Voiding habits were assessed by completion of a frequency-volume chart recording all fluid intakes and voiding. A concomitant 24-hour blood pressure profile was obtained in all.
Renal transplant recipients had a high prevalence of nocturnal polyuria (74%) and a disturbed blood pressure profile with a lack of appropriate nocturnal dipping (P
Men aged 45 to 80, in good health, with moderate BPH and no evidence of prostate cancer. A total of 613 men were entered into the study; 472 completed the 2 years of treatment.
After 1 month of receiving a placebo (run-in period), patients were given either finasteride (5 mg/d) or a placebo for 2 years.
changes from baseline in BPH symptom scores, maximum urinary flow rates and prostate volume.
onset, course and resolution of all adverse events during the treatment period.
In the efficacy analyses the mean BPH symptom scores decreased 2.1 points (from 15.8 to 13.7) in the finasteride group, as compared with a decrease of 0.7 points (from 16.6 to 15.9) in the placebo group (P
To assess the efficacy and safety, and determine the optimal dosage, of a once-daily (OD) formulation of the clinically uroselective alpha(1)-blocker, alfuzosin, in patients with lower urinary tract symptoms and symptomatic benign prostatic hyperplasia.
Five hundred thirty-six patients were randomized to receive alfuzosin (10 mg OD or 15 mg OD), without initial dose titration, or placebo in a 3-month double-blind trial conducted in North America. The primary efficacy criteria were improvement in symptoms (International Prostate Symptom Score) and peak urinary flow rate.
Alfuzosin was significantly more effective than placebo in improving the symptoms and peak urinary flow rate from the first follow-up visit (day 28). The mean change in the International Prostate Symptom Score from baseline at endpoint was -3.6 and -3.4 with alfuzosin 10 mg and 15 mg, respectively, compared with -1.6 with placebo (alfuzosin 10 mg versus placebo, P = 0.001; alfuzosin 15 mg versus placebo, P = 0.004). The median increase in the peak urinary flow rate was +1.1 mL/s and +1.0 mL/s with alfuzosin 10 mg and 15 mg, respectively, compared with 0.0 mL/s with placebo (P = 0.0006 versus placebo for both dose groups). The patients' quality of life also significantly improved with both alfuzosin doses. Overall, alfuzosin at both doses was well tolerated. The incidence of orthostatic hypotension as determined by systematic blood pressure measurements with both doses of alfuzosin was similar to placebo. No clinically relevant ejaculation disorders were observed with alfuzosin.
Alfuzosin 10 mg OD, administered without dose titration, provides effective relief from the symptoms of benign prostatic hyperplasia with no additional benefit from a 15-mg dose. It is well tolerated from a cardiovascular viewpoint and is not associated with abnormal ejaculation.
1. The aim of this study was to elucidate the role of atrial natriuretic peptides in the regulation of water and electrolyte balance after alcohol intake. To this end we measured the plasma concentrations of ethanol, atrial natriuretic peptide 99-126 and the N-terminal fragment of pro-atrial natriuretic peptide (atrial natriuretic peptide 1-98), serum osmolality and serum sodium concentration, and urine output, urine osmolality and urinary sodium excretion for 12 h after administration of ethanol (0, 0.5 and 1.0 g body weight/kg) and placebo drinks to nine healthy subjects according to a double-blind cross-over design. 2. Intake of ethanol (at 19.00-19.45 hours) inhibited the nocturnal increase in the plasma atrial natriuretic peptide 99-126 level dose-dependently (P
The effects of finasteride, a potent 5 alpha-reductase inhibitor, were assessed in patients with benign prostatic hyperplasia. Patients were treated with finasteride or placebo for 24 weeks in a double-blind multicenter study followed by a 12-month open-extension period. After 24 weeks, finasteride-treated patients, when compared to placebo-treated patients, showed a significant reduction in prostate volume (22.5% median decrease) and prostate significant antigen (32.4% median decrease), a significant increase in maximum urinary flow (1.6 ml/s mean increase from baseline) and a significant improvement in their obstructive symptom scores (two-point decrease from baseline). Finasteride was well tolerated, and the improvements in prostate volume, maximum urinary flow rate and obstructive symptom scores observed in the controlled study were maintained throughout the extension study.
A scheme is proposed for the evaluation of the efficacy of the effect of those kinds of water containing little of mineral natural substances and having medicinal value, on the functions of bile secretion and urination. Using discriminant and component analyses, there has been formed a pragmatic classification of under-mineralized medicinal waters of Ukraine to be introduced into widespread use in practical public health care.
The main purpose of the study was to determine the effectiveness of a multicomponent dietary supplement ProstaDoz in patients with chronic prostatitis. The study included 50 men with clinical symptoms of a chronic prostatitis, which were observed in 9 clinical centers in different regions of Russia. All patients have received 2 capsules of ProstaDoz twice a day for 1 month, followed by dynamic observation for 4 weeks. Symptomatic improvement was achieved in 46 (92%) patients. Evaluation of effects of ProstaDoz on various groups of symptoms has revealed that it reduces pain, promotes urination normalization and improvement of quality of life. These effects were maintained during all follow-up period.
Urodynamic investigations provide an objective, quantitative evaluation of urinary function in patients with benign prostatic obstruction (BPO). The effects of doxazosin, a selective alpha 1-adrenoceptor antagonist, on urodynamic measurements were investigated in three double-blind, placebo-controlled clinical studies of the treatment of BPO.
302 normotensive and mildly hypertensive men with BPO were evaluated. Patients were randomized to receive doxazosin (1-4 mg o.d.) or placebo for 4-29 weeks.
Doxazosin significantly improved free urinary flow rates compared with placebo. Urodynamic studies confirmed that doxazosin was effective in improving urinary flow, and also showed a reduction in detrusor pressure, resulting in decreased voiding time and increased voided volume. Analysis of pressure-flow data demonstrated a significant reduction in a measure of urethral resistance in doxazosin-treated patients.
These results indicate that doxazosin is an important treatment option for patients with troublesome lower urinary tract symptoms and BPO.