![]() Considering the characteristics of the Chinese population and the availability of 0.1 mg dDAVP tablets in the Chinese marketplace, a treatment regimen that starts at 0.2 mg and increases doses by 0.1 mg every 2 weeks for non-responders until a complete response is achieved is suggested in China, although the efficacy of this strategy has not been well-evaluated. However, previous evidence has shown that this strategy seems insufficient to further improve the efficacy and even results in unnecessarily high doses for some individuals ( 7, 8). For partial responders and non-responders, dDAVP is often increased by 0.2 mg increments to the maximal recommended dose until dryness is achieved. The standard recommended dose for treating MNE is 0.2–0.4 mg tablets, and the literature strongly supports that the dose should be gradually increased until dryness is achieved ( 4– 6). Patients without daytime symptoms are categorized as having monosymptomatic nocturnal enuresis (MNE) and desmopressin (dDAVP) is a first-line therapy for patients with MNE. NE is a common disorder in children, with a prevalence of 15–20% in 5-year-olds, 7% in 7-year-olds, 5% in 10-year-olds, 1–2% in 15-year-olds and ~1% in adults ( 2, 3). Nocturnal enuresis (NE) is defined as the involuntary voiding of urine at night in children aged 5 years or older ( 1). Low-dose responders were likely to achieve a complete response without increasing the dose in these cases, the maximum dose might not be necessary. Ĭonclusions: Our results indicate that the dDAVP treatment regimen provides a comparable efficacy to the international conventional treatment regimen with a lower overall dose. Multivariate analysis showed that patients requiring lower doses to achieve responses were significantly more likely to experience complete response during the maintenance period. At the end of the study, 194/225 (86.2%) patients received a final dose of 0.2 mg, 24/225 (10.7%) patients received a final dose of 0.3 mg, and 7/225 (3.1%) patients received a final dose of 0.4 mg. The intention to treat analysis showed that the overall dDAVP response rate was 69.9%: among these patients 32.3% were complete responders, and 37.6% were partial responders. Results: Overall, 322 MNE patients were enrolled in our study, and 225 (69.9%) completed the study. ![]() Predictive factors were evaluated by logistic regression analysis. The efficacy of dDAVP was assessed according to the latest International Children's Continence Society criteria at the end of the study. dDAVP treatment comprised a dose titration period and a 3-month maintenance period. Methods: All MNE patients at the Department of Nephrology at Children's Hospital of Fudan University from January to December 2019 were prospectively and consecutively enrolled. Our study aimed to assess the efficacy of our modified dDAVP treatment regimen in children with MNE in China and evaluate predictive factors associated with the dDAVP response. However, previous evidence has shown that this strategy seems insufficient to further improve efficacy and results in unnecessarily high doses for some patients. 2 mg/day, and most guidelines recommend that the dose should be increased at 0.2 mg increments until dryness is achieved or to the maximal recommended dose. The standard initial dosage of dDAVP is 0. Objectives: Nocturnal enuresis (NE) is a common pediatric condition, and desmopressin (dDAVP) is a first-line therapy for NE. 2Department of Urology, Children's Hospital of Fudan University, Shanghai, China.1Department of Nephrology, Children's Hospital of Fudan University, National Pediatric Medical Center of China, Shanghai, China.Physical exam should include vital signs, neurological exam, and examination of the tonsilar size, suprapubic area, abdomen, external genitalia, and lumbosacral spine.Jiaojiao Liu 1 † Jiajia Ni 1 † Qianfan Miao 1 † Chunyan Wang 1 Fang Lin 1 Qi Cao 1 Wei Guo 1 Xue Yang 1 Xiaolu Ji 1 Yihui Zhai 1 Yunli Bi 2 Qian Shen 1 * Hong Xu 1 * Urine is collected using a collecting pan, also known as a "Texas Hat." The collecting pan can be obtained from the physician's office or medical supply stores. It can also include bed and wake times. Ideally, the diary should be done for at least three days consistently. Obtain a voiding diary that logs the wet days or wet nights (voiding pattern), the volume of urine, the volume of fluid intake (hydration history), and the urge to urinate on a provided scale. ![]() Ask about any family history of enuresis and specific detailed questions that rule out differential diagnoses, such as urinary tract infection, constipation, seizure, diabetes, or sleep apnea. In addition to the standard medical, surgical, and family histories, it is important to obtain more details regarding toilet training, nutrition, and sleep histories. Secondary enuresis means continence was achieved then lost.
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