Female Urology, Urodynamics, Incontinence, and Pelvic Floor Reconstructive Surgery| Volume 106, P60-64, August 2017

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Dietary Sodium Restriction Reduces Nocturnal Urine Volume and Nocturnal Polyuria Index in Renal Allograft Recipients With Nocturnal Polyuria


      To investigate whether sodium restriction alters the nocturnal urine volume (NUV) and the ratio of NUV to 24-hour urine of renal allograft recipients (RARs).

      Materials and Methods

      This prospective, single-center study analyzed 38 of the 59 RARs who were followed up for more than 6 months in our hospital. All patients underwent 3 sessions of dietary counseling performed by a board-certified dietitian. Before and after these 3 sessions, 24-hour urine samples were collected, along with voiding frequency volume charts.


      Of the 38 included RARs, 23 (60.5%) were diagnosed as having nocturnal polyuria (NP, NUV >10 mL/kg). After counseling the RARs with NP, their 24-hour sodium excretion was reduced from 169.5 to 125.6 mEq (P = .0066), their NUV from 862 to 709 mL (P = .021), and the ratio of NUV to 24-hour urine volume from 38.9% to 33.0% (P = .023). In contrast, these parameters were not significantly changed by dietary counseling in RARs without NP. Reduced sodium excretion and decreased NUV were significantly correlated (Spearman rho = 0.45, P = .005).


      Excess intake of sodium is considered a cause of NP in RARs. Dietary counseling on sodium restriction is effective in reducing NUV in RARs. Prospective studies are needed to evaluate the general population with NP.
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        • Mitsui T.
        • Moriya K.
        • Morita K.
        • et al.
        Risk factors for lower urinary tract dysfunction and symptoms after successful renal transplantation.
        Ann Transplant. 2015; 20: 757-763
        • Van der Weide M.J.A.
        • Van Achterberg T.
        • Smits J.P.J.M.
        • et al.
        Causes of frequency and nocturia after renal transplantation.
        BJU Int. 2008; 101: 1029-1034
        • Mizerski A.
        • Ostrowska Clark K.
        • Ostrowski M.
        • et al.
        Postoperative adaptation of urinary bladder to variable volume of urine in the initial period following kidney transplantation.
        Transplant Proc. 2003; 35: 2174-2175
        • Zermann D.H.
        • Janitzky A.
        • Höhne M.
        • et al.
        Frequency and nocturia after successful renal transplantation: a normal situation?.
        BJU Int. 2006; 97: 555-558
        • Hofmeester I.
        • Kollen B.J.
        • Steffens M.G.
        • et al.
        The association between nocturia and nocturnal polyuria in clinical and epidemiological studies: a systematic review and meta-analyses.
        J Urol. 2014; 191: 1028-1033
        • Alstrup K.
        • Graugaard-Jensen C.
        • Rittig S.
        • et al.
        Abnormal diurnal rhythm of urine output following renal transplantation: the impact of blood pressure and diuretics.
        Transplant Proc. 2010; 42: 3529-3536
        • Weiss J.P.
        • Bosch J.L.
        • Drake M.
        • et al.
        Nocturia think tank: focus on nocturnal polyuria: ICI-RS 2011.
        Neurourol Urodyn. 2012; 31: 330-339
        • Soypacaci Z.
        • Sengul S.
        • Yıldız E.A.
        • et al.
        Effect of daily sodium intake on post-transplant hypertension in kidney allograft recipients.
        Transplant Proc. 2013; 45: 940-943
        • Asai K.
        • Kobayashi T.
        • Miyata H.
        • et al.
        The short-term impact of dietary counseling on sodium intake and blood pressure in renal allograft recipients.
        Prog Transplant. 2016; 26: 365-371
        • de Vries L.V.
        • Dobrowolski L.C.
        • van den Bosch J.J.O.N.
        • et al.
        Effects of dietary sodium restriction in kidney transplant recipients treated with renin-angiotensin-aldosterone system blockade: a randomized clinical trial.
        Am J Kidney Dis. 2016; 67: 936-944
        • Van Hoeck K.
        • Bael A.
        • Lax H.
        • et al.
        Circadian variation of voided volume in normal school-age children.
        Eur J Pediatr. 2007; 166: 579-584
        • Homma Y.
        • Yamaguchi O.
        • Kageyama S.
        • et al.
        Nocturia in the adult: classification on the basis of largest voided volume and nocturnal urine production.
        J Urol. 2000; 163: 777-781
        • Coffman T.M.
        The inextricable role of the kidney in hypertension.
        J Clin Invest. 2014; 124: 2341-2347
        • DeSalvo K.B.
        • Olson R.
        • Casavale K.O.
        Dietary guidelines for Americans.
        JAMA. 2016; 315: 457
        • Goessaert A.S.
        • Krott L.
        • Walle J.V.
        • et al.
        Exploring nocturia: gender, age, and causes.
        Neurourol Urodyn. 2015; 34: 561-565
        • Cho S.Y.
        • Lee S.L.
        • Kim I.S.
        • et al.
        Short-term effects of systematized behavioral modification program for nocturia: a prospective study.
        Neurourol Urodyn. 2012; 31: 64-68
        • Powles J.
        • Fahimi S.
        • Micha R.
        • et al.
        Global, regional and national sodium intakes in 1990 and 2010: a systematic analysis of 24 h urinary sodium excretion and dietary surveys worldwide.
        BMJ Open. 2013; 3: e003733
        • Mangray M.
        • Vella J.P.
        Hypertension after kidney transplant.
        Am J Kidney Dis. 2011; 57: 331-341
        • Kopp U.C.
        • Grisk O.
        • Cicha M.Z.
        • et al.
        Dietary sodium modulates the interaction between efferent renal sympathetic nerve activity and afferent renal nerve activity: role of endothelin.
        Am J Physiol Regul Integr Comp Physiol. 2009; 297: R337-R351
        • Kopp U.C.
        • Cicha M.Z.
        • Smith L.A.
        • et al.
        Dietary sodium modulates the interaction between efferent and afferent renal nerve activity by altering activation of α2-adrenoceptors on renal sensory nerves.
        Am J Physiol Regul Integr Comp Physiol. 2011; 300: R298-R310
        • Chan M.K.
        • Varghese Z.
        • Fernando O.N.
        • et al.
        Nocturnal polyuria and saluresis in renal allograft recipients.
        Br Med J. 1980; 280: 150-151
        • Kurtz T.W.
        • DiCarlo S.E.
        • Pravenec M.
        • et al.
        An alternative hypothesis to the widely held view that renal excretion of sodium accounts for resistance to salt-induced hypertension.
        Kidney Int. 2016; 90: 965-973
        • WHO
        Guideline: Sodium Intake for Adults and Children.
        World Health Organization (WHO), Geneva2012