Prevalence, incidence, and resolution of nocturnal polyuria in a longitudinal community-based study in older men: the Krimpen study.

BACKGROUND

Nocturnal polyuria (NP) is common in older men and can lead to nocturia. However, no longitudinal data are available on the natural history of NP.

OBJECTIVE

To determine prevalence, incidence, and resolution rates of NP.

DESIGN, SETTING, AND

PARTICIPANTS

A longitudinal, community-based study was conducted among 1688 men aged 50-78 yr in Krimpen aan den IJssel, The Netherlands (reference date: 1995), with planned follow-up rounds at 2, 4, and 6 yr.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: NP was determined with frequency-volume charts. Two definitions of NP were used: (1) a nocturnal urine production (NUP) of >90 ml/h (NUP90) and (2) the nocturnal voided volume plus first morning void being >33% of the 24-h voided volume (NUV33). Nocturia was defined as two or more voids per night. We determined the prevalence of NP at each study round. At first follow-up, we determined the incidence in men without baseline NP and the resolution in men with baseline NP. Prevalence of NP in men with or without nocturia was also determined.

RESULTS AND LIMITATIONS: At baseline, the prevalence of NUP90 was 15.0% and increased to 21.7% after 6.5 yr, whereas the prevalence of NUV33 was 77.8% at baseline and 80.5% after 6.5 yr. At 2.1 yr of follow-up, the incidences of NUP90 and NUV33 were 13.6% and 60.3%, respectively, and the resolution rates were 57.0% and 17.8%, respectively. Because of this fluctuation in NP, no reliable long-term incidences could be calculated. At baseline, NUP90 was prevalent in 27.7% of men with nocturia and in 8.0% of those without nocturia. At baseline, NUV33 was prevalent in 91.9% of men with nocturia and in 70.1% of men without nocturia.

CONCLUSIONS

Due to the fluctuation of NP, it is advisable to first determine its chronicity and cause before starting treatment. Because of the high prevalence of NP in men without nocturia, NUV33 should be reconsidered as a discriminative definition of NP.