Nocturia: The Complex Role of the Heart, Kidneys, and Bladder.

Lombardo, Riccardo; Tubaro, Andrea; Burkhard, Fiona (2020). Nocturia: The Complex Role of the Heart, Kidneys, and Bladder. European urology focus, 6(3), pp. 534-536. Elsevier 10.1016/j.euf.2019.07.007

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We review the role of the heart, kidneys, and bladder in the pathophysiology of nocturia and nocturnal polyuria. Lower urinary tract symptoms such as nocturia have often been associated with lower urinary tract dysfunction. It is known that the bladder contributes to nocturia in the case of low functional capacity, urgency, and detrusor overactivity. Heart diseases, especially arterial hypertension and congestive heart failure, are closely related to nocturnal polyuria. The main mechanisms include renal hyperfiltration and elevated atrial natriuretic peptide. A number of drugs frequently used in cardiovascular disorders are implicated in nocturia; diuretics, calcium channel blockers, and β-blockers induce nocturnal polyuria and thus nocturia, whereas alpha-blockers improve nocturia. Among the different forms of hypertension, nondipping arterial hypertension has been associated with a higher risk of nocturnal polyuria. Besides the role of the kidneys in nocturia linked to arterial hypertension, chronic kidney disease is an independent predictor of nocturia through an osmotic diuresis mechanism. Some evidence suggests a close relationship between the heart (nondipping arterial hypertension), kidneys (chronic kidney disease), and nocturia/nocturnal polyuria. These complex interactions between the heart, kidneys, and bladder warrant a multidisciplinary approach in patients with nocturia. PATIENT SUMMARY: We review the different mechanisms that lead to nocturia and nocturnal polyuria. The complex interactions between the heart, the kidneys, and the bladder warrant a multidisciplinary approach in patients with nocturia. Careful investigation of the cause of nocturia can improve its management.

Item Type:	Journal Article (Review Article)
Division/Institute:	04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology
UniBE Contributor:	Burkhard, Fiona Christine
Subjects:	600 Technology > 610 Medicine & health
ISSN:	2405-4569
Publisher:	Elsevier
Language:	English
Submitter:	Jeannine Wiemann
Date Deposited:	12 Nov 2019 15:30
Last Modified:	02 Mar 2023 23:32
Publisher DOI:	10.1016/j.euf.2019.07.007
PubMed ID:	31395515
Uncontrolled Keywords:	Nocturia Nocturnal polyuria Physiopathology
URI:	https://boris.unibe.ch/id/eprint/134925