Nocturnal polyuria is common in Parkinson’s and is associated with orthostatic hypotension
Background: Nocturia is the most common lower urinary tract symptom (LUTS) in Parkinson’s disease (PD) and impacts sleep and subsequent daytime function. Often nocturia in PD is attributed to overactive bladder, however we explored the contribution of the over-production of urine at night, nocturnal...
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Elsevier
2025-01-01
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| Series: | Clinical Parkinsonism & Related Disorders |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590112525000386 |
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| author | Matthew D Smith Anisha Cullen Gabriella E Portlock Marcus J Drake Yoav Ben-Shlomo Emily J Henderson |
| author_facet | Matthew D Smith Anisha Cullen Gabriella E Portlock Marcus J Drake Yoav Ben-Shlomo Emily J Henderson |
| author_sort | Matthew D Smith |
| collection | DOAJ |
| description | Background: Nocturia is the most common lower urinary tract symptom (LUTS) in Parkinson’s disease (PD) and impacts sleep and subsequent daytime function. Often nocturia in PD is attributed to overactive bladder, however we explored the contribution of the over-production of urine at night, nocturnal polyuria (NP), as another factor. Objectives: To assess the prevalence and severity of NP in a PD cohort with LUTS and explore associations with autonomic and other patient characteristics. Methods: Sub-study nested within a trial for LUTS in PD. All participants performed 72-hour bladder diaries. Nocturnal polyuria index (NPi) was calculated from diaries and key associations were explored. Results: 62.6 % of participants had NP based on the NPi33 threshold (producing > 33 % urine at night). Increasing NPi was strongly significantly associated with greater nocturia (OR 1.7 per 5 % NPi unit; 1.5–2.0; P < 0.001). A significant association was observed between NPi and orthostatic hypotension (OR 1.2 per 5 % NPi unit increase; 1.0–1.4; P = 0.03) and reported cardiovascular symptoms (coefficient 0.07; 0.03–0.11; P = 0.002). A marked association was seen with severe NP and orthostatic hypotension (OR 4.9; 1.56–15.57; P = 0.006). Conclusion: NP is very common in this PD cohort symptomatic for LUTS, and is closely associated with increasing rate of nocturia. NP is linked to cardiovascular symptoms and autonomic dysfunction, particularly blood pressure lability which may be causal or simply reflect advanced disease state. |
| format | Article |
| id | doaj-art-acac4b33b7054fd2945a8382e9ce6b94 |
| institution | Kabale University |
| issn | 2590-1125 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Parkinsonism & Related Disorders |
| spelling | doaj-art-acac4b33b7054fd2945a8382e9ce6b942025-08-20T03:51:58ZengElsevierClinical Parkinsonism & Related Disorders2590-11252025-01-011210033410.1016/j.prdoa.2025.100334Nocturnal polyuria is common in Parkinson’s and is associated with orthostatic hypotensionMatthew D Smith0Anisha Cullen1Gabriella E Portlock2Marcus J Drake3Yoav Ben-Shlomo4Emily J Henderson5Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Department of Neurology, Southmead Hospital, Bristol, BS10 5NB, UK; Corresponding author at: Canynge Hall, University of Bristol, BS8 2PN, UK.Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UKPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UKImperial College, London, UKPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UKPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Older People’s Unit, Royal United Hospital, Bath, UKBackground: Nocturia is the most common lower urinary tract symptom (LUTS) in Parkinson’s disease (PD) and impacts sleep and subsequent daytime function. Often nocturia in PD is attributed to overactive bladder, however we explored the contribution of the over-production of urine at night, nocturnal polyuria (NP), as another factor. Objectives: To assess the prevalence and severity of NP in a PD cohort with LUTS and explore associations with autonomic and other patient characteristics. Methods: Sub-study nested within a trial for LUTS in PD. All participants performed 72-hour bladder diaries. Nocturnal polyuria index (NPi) was calculated from diaries and key associations were explored. Results: 62.6 % of participants had NP based on the NPi33 threshold (producing > 33 % urine at night). Increasing NPi was strongly significantly associated with greater nocturia (OR 1.7 per 5 % NPi unit; 1.5–2.0; P < 0.001). A significant association was observed between NPi and orthostatic hypotension (OR 1.2 per 5 % NPi unit increase; 1.0–1.4; P = 0.03) and reported cardiovascular symptoms (coefficient 0.07; 0.03–0.11; P = 0.002). A marked association was seen with severe NP and orthostatic hypotension (OR 4.9; 1.56–15.57; P = 0.006). Conclusion: NP is very common in this PD cohort symptomatic for LUTS, and is closely associated with increasing rate of nocturia. NP is linked to cardiovascular symptoms and autonomic dysfunction, particularly blood pressure lability which may be causal or simply reflect advanced disease state.http://www.sciencedirect.com/science/article/pii/S2590112525000386Parkinson’s diseaseAutonomicBladderUrinaryBlood pressure |
| spellingShingle | Matthew D Smith Anisha Cullen Gabriella E Portlock Marcus J Drake Yoav Ben-Shlomo Emily J Henderson Nocturnal polyuria is common in Parkinson’s and is associated with orthostatic hypotension Clinical Parkinsonism & Related Disorders Parkinson’s disease Autonomic Bladder Urinary Blood pressure |
| title | Nocturnal polyuria is common in Parkinson’s and is associated with orthostatic hypotension |
| title_full | Nocturnal polyuria is common in Parkinson’s and is associated with orthostatic hypotension |
| title_fullStr | Nocturnal polyuria is common in Parkinson’s and is associated with orthostatic hypotension |
| title_full_unstemmed | Nocturnal polyuria is common in Parkinson’s and is associated with orthostatic hypotension |
| title_short | Nocturnal polyuria is common in Parkinson’s and is associated with orthostatic hypotension |
| title_sort | nocturnal polyuria is common in parkinson s and is associated with orthostatic hypotension |
| topic | Parkinson’s disease Autonomic Bladder Urinary Blood pressure |
| url | http://www.sciencedirect.com/science/article/pii/S2590112525000386 |
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