Does hormonal therapy affect the bladder or the kidney in postmenopausal women with and without nocturnal polyuria: Results of a pilot trial?. (June 2022)

• Record Type: Journal Article
• Authors: Pauwaert, Kim; Bruneel, Elke; Van Laecke, Erik; Depypere, Herman; Everaert, Karel; Goessaert, An-Sofie
• Is Part Of: Maturitas. Volume 160(2022)
• Page Start: 61
• Page End: 67
• Publication Date: 2022-06
• Subjects: Menopause -- Hormonal treatment -- Circadian rhythm -- Voiding dysfunctions -- Nocturnal polyuria; ADH antidiuretic hormone -- ANP atrial natriuretic peptide -- FWC free water clearance -- FVC frequency volume chart -- HT hormonal treatment HT hormonal treatment -- ICS International Continence Society -- IQR interquartile range -- LUTS lower urinary tract symptoms -- NP nocturnal polyuria -- NPI Nocturnal Polyuria Index -- OAC oral anticonception -- RAAS renin angiotensin aldosterone system -- RFP renal function profile; Climacteric -- Periodicals; Menopause -- Periodicals; Climacteric -- Periodicals; Geriatrics -- Periodicals; Menopause -- Periodicals; Middle Aged -- Periodicals; Climatère -- Périodiques; Ménopause -- Périodiques; Climacterium; Climacteric; Menopause; Electronic journals; Periodicals; 612.66
• DOI: 10.1016/j.maturitas.2022.01.009
• Languages: English
• ISSNs: 0378-5122

Abstract

Highlights: Hormonal therapy led to a significant reduction in fluid intake and daytime frequency of urination. Hormonal therapy impacted the circadian rhythms of diuresis rate and sodium clearance negatively in women without nocturnal polyuria. Women with nocturnal polyuria experienced a significant effect of hormonal therapy on nightly free water clearance. Abstract: Aim: To observe the impact of hormonal treatment (HT) on voiding patterns and renal circadian rhythms in postmenopausal women with and without nocturnal polyuria (NP). Material and Methods: A prospective, observational study was executed at the menopause clinic of a tertiary hospital. HT was based on patients' choice and was in the form of either oral and transdermal oestrogen. Participants completed a 72-hour bladder diary, completed the ICIQ-FLUTS questionnaire, recorded a renal function profile and gave a blood sample. This set of tests was done before and after 3 months of HT. Results: 32 postmenopausal women with a median age of 52.5 (49.3–56.0) years were enroled in this study. Three months of HT resulted in a significant decrease in fluid intake ( p < 0.001) and daytime voiding frequency ( p = 0.019). No impact on nocturnal parameters was observed. Observations drawn from the questionnaires did not differ between the baseline and three-month assessments. HT led to a disappearance of the circadian rhythm of the diuresis rate and sodium clearance in patients without NP, as no significant difference between daytime and night-time values was observed (diuresis rate p = 0.3; sodium clearance p = 0.08). In patients with NP at baseline, HT did not induce a circadian rhythm of the diuresis rate and sodium clearance ( p = 0.2; p = 0.7). In contrast, free water clearance did change to a clear circadian rhythm ( p = 0.02). Conclusion: HT led to a significant reduction in both fluid intake and daytime frequency. In women without NP, HT led to a disruption of the circadian rhythms of water and salt diuresis. In patients with NP, a limited normalisation of the circadian rhythm of free water clearance was observed after three months of HT. Clinical trial registration number from ClinicalTrials.gov: NCT04891926