Relationship between use of desmopressin in male patients with lower urinary tract symptoms and occurrence of hyponatremia: A nationwide population-based study using the National Health Insurance Service database

Purpose: Desmopressin, frequently prescribed for nocturia, is associated with an elevated risk of hyponatremia. This study examined the incidence and risk factors of hyponatremia in male patients with benign prostatic hyperplasia using nationwide Korean health data. Materials and Methods: From the...

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Main Authors: Byeong Jo Jeon, Bum Sik Tae, Jae Young Park, Jae Hyun Bae
Format: Article
Language:English
Published: Korean Urological Association 2025-05-01
Series:Investigative and Clinical Urology
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Online Access:https://www.icurology.org/pdf/10.4111/icu.20240433
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author Byeong Jo Jeon
Bum Sik Tae
Jae Young Park
Jae Hyun Bae
author_facet Byeong Jo Jeon
Bum Sik Tae
Jae Young Park
Jae Hyun Bae
author_sort Byeong Jo Jeon
collection DOAJ
description Purpose: Desmopressin, frequently prescribed for nocturia, is associated with an elevated risk of hyponatremia. This study examined the incidence and risk factors of hyponatremia in male patients with benign prostatic hyperplasia using nationwide Korean health data. Materials and Methods: From the National Health Insurance Service database, we analyzed data on desmopressin and hyponatremia in Korean adults with benign prostatic hyperplasia between 2011 and 2012. The patients were followed-up until December 2020. We tested the effects of desmopressin on hyponatremia risk using propensity score-matched Cox regression models and Kaplan–Meier survival analysis. Results: Among 33,533 patients, the incidence of hyponatremia was 6.0%, 4.5%, and 5.0% in the desmopressin, alpha-blocker, and combination therapy groups, respectively. After propensity score matching, desmopressin use was not significantly associated with an increased risk of hyponatremia (hazard ratio 1.273, 95% confidence interval 0.988–1.640; p=0.062). Significant predictors of hyponatremia included advanced age, chronic heart failure, peripheral vascular disease, and renal disease. Conclusions: Desmopressin prescription following careful patient selection and regular monitoring does not significantly increase the risk of hyponatremia compared to other lower urinary tract symptom treatments. Therefore, it remains a viable and effective option for managing nocturia, particularly in patients with nocturnal polyuria. However, clinicians should implement routine monitoring protocols, including serum sodium checks, particularly in high-risk populations, to ensure the safe and effective use of desmopressin.
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spelling doaj-art-d4c3bc74ce7e4091b2df148d2ea67c172025-08-20T03:09:41ZengKorean Urological AssociationInvestigative and Clinical Urology2466-04932466-054X2025-05-0166324525010.4111/icu.20240433Relationship between use of desmopressin in male patients with lower urinary tract symptoms and occurrence of hyponatremia: A nationwide population-based study using the National Health Insurance Service databaseByeong Jo Jeon0https://orcid.org/0000-0002-8598-6635Bum Sik Tae1https://orcid.org/0000-0003-2963-7366Jae Young Park2https://orcid.org/0000-0002-6664-6846Jae Hyun Bae3https://orcid.org/0000-0001-9862-3545Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.Purpose: Desmopressin, frequently prescribed for nocturia, is associated with an elevated risk of hyponatremia. This study examined the incidence and risk factors of hyponatremia in male patients with benign prostatic hyperplasia using nationwide Korean health data. Materials and Methods: From the National Health Insurance Service database, we analyzed data on desmopressin and hyponatremia in Korean adults with benign prostatic hyperplasia between 2011 and 2012. The patients were followed-up until December 2020. We tested the effects of desmopressin on hyponatremia risk using propensity score-matched Cox regression models and Kaplan–Meier survival analysis. Results: Among 33,533 patients, the incidence of hyponatremia was 6.0%, 4.5%, and 5.0% in the desmopressin, alpha-blocker, and combination therapy groups, respectively. After propensity score matching, desmopressin use was not significantly associated with an increased risk of hyponatremia (hazard ratio 1.273, 95% confidence interval 0.988–1.640; p=0.062). Significant predictors of hyponatremia included advanced age, chronic heart failure, peripheral vascular disease, and renal disease. Conclusions: Desmopressin prescription following careful patient selection and regular monitoring does not significantly increase the risk of hyponatremia compared to other lower urinary tract symptom treatments. Therefore, it remains a viable and effective option for managing nocturia, particularly in patients with nocturnal polyuria. However, clinicians should implement routine monitoring protocols, including serum sodium checks, particularly in high-risk populations, to ensure the safe and effective use of desmopressin.https://www.icurology.org/pdf/10.4111/icu.20240433benign prostatic hyperplasiadesmopressinhyponatremiainsurance healthlower urinary tract symptoms
spellingShingle Byeong Jo Jeon
Bum Sik Tae
Jae Young Park
Jae Hyun Bae
Relationship between use of desmopressin in male patients with lower urinary tract symptoms and occurrence of hyponatremia: A nationwide population-based study using the National Health Insurance Service database
Investigative and Clinical Urology
benign prostatic hyperplasia
desmopressin
hyponatremia
insurance health
lower urinary tract symptoms
title Relationship between use of desmopressin in male patients with lower urinary tract symptoms and occurrence of hyponatremia: A nationwide population-based study using the National Health Insurance Service database
title_full Relationship between use of desmopressin in male patients with lower urinary tract symptoms and occurrence of hyponatremia: A nationwide population-based study using the National Health Insurance Service database
title_fullStr Relationship between use of desmopressin in male patients with lower urinary tract symptoms and occurrence of hyponatremia: A nationwide population-based study using the National Health Insurance Service database
title_full_unstemmed Relationship between use of desmopressin in male patients with lower urinary tract symptoms and occurrence of hyponatremia: A nationwide population-based study using the National Health Insurance Service database
title_short Relationship between use of desmopressin in male patients with lower urinary tract symptoms and occurrence of hyponatremia: A nationwide population-based study using the National Health Insurance Service database
title_sort relationship between use of desmopressin in male patients with lower urinary tract symptoms and occurrence of hyponatremia a nationwide population based study using the national health insurance service database
topic benign prostatic hyperplasia
desmopressin
hyponatremia
insurance health
lower urinary tract symptoms
url https://www.icurology.org/pdf/10.4111/icu.20240433
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