Nocturnal polyuria and antidiuretic hormone levels in spinal cord injury.

OBJECTIVE

To establish baseline ADH levels in spinal cord injury patients and to evaluate whether spinal cord patients have attenuation of diurnal variation of ADH similar to children with enuresis and elderly with nocturnal polyuria.

DESIGN

Twenty-seven healthy quadriplegic patients, ASIA impairment scale A, were evaluated for serum ADH levels at night and during the day.

MAIN OUTCOME MEASURES: Evaluation of whether bladder overdistention caused by attenuation of diurnal variation of ADH is responsible for the episodes of autonomic dysreflexia and recurrent urinary tract infections in spinal cord injury patients who are on intermittent catheterization for bladder management.

RESULTS

A lack of diurnal variation of ADH in the subject population.

CONCLUSIONS

A trial of desaminocystein-D-arginine vasopressin (DDAVP) should be considered for patients with established attenuation of the diurnal variation ADH.