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Aim: We investigated whether the daily salt intake of children with nocturnal enuresis influenced their response to 1-desamino-8-D-arginine vasopressin therapy., Methods: This study comprised 129 children (67.4% boys) with a median age of 9.2 years (range 7.2-10.4) with monosymptomatic nocturnal enuresis who were seen at Kansai Medical University Hospital, Osaka, Japan, from 2013 to 2017. Urinary sodium concentrations were determined using a spot urine test, and the children were divided into appropriate (n = 55) and excessive salt intake (n = 74) groups based on Japanese Government guidelines. After a month of therapy, the treatment responses were compared for 39 and 50 children, respectively., Results: There were no significant differences in the urea nitrogen-to-creatinine or calcium-to-creatinine ratios in the two groups. However, the excessive salt intake group showed a significantly reduced treatment response to the appropriate salt intake group. In addition, the excessive and appropriate salt intake groups showed median efficacy ratios of 8.2% and 21.8%, respectively, based on intention-to-treat analysis (P = 0.029) and 12.0% and 30.8% based on per-protocol analysis (P = 0.029)., Conclusion: High daily salt intake significantly reduced the efficacy of ddavp therapy for nocturnal enuresis and consumption should be controlled during treatment., (©2019 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Purpose: Alarm therapy is widely used as first line treatment for nocturnal enuresis. However, some children do not wake when nocturnal urination activates the alarm. It is currently unclear whether waking the child when the alarm is activated improves the efficacy of alarm therapy. In this study we investigated the efficacy of alarm therapy for nocturnal enuresis when children do not wake in response to the sound and their parents do not wake them., Materials and Methods: Detailed information regarding incontinence was retrospectively obtained from 78 of 112 patients who underwent alarm therapy between 2006 and 2016, and completed a questionnaire and a 14-day bladder diary. The enrolled patients were divided into 2 groups. In the family assisted group (44) the children were awakened by family members when the alarm sounded. In the alarm control group (34) the children were self-responsible for waking to the alarm. The groups were compared to investigate differences at 16 weeks after alarm therapy began. The efficacy rate was calculated using the International Children's Continence Society criteria., Results: The efficacy was similar between the groups. Full response and partial response were observed in 36.4% and 20.5% of patients in the family assisted group, and 26.5% and 29.4% of patients in the alarm control group (p = 1.00), respectively. There was no significant difference in the percentage of children who woke spontaneously to the alarm in the 2 groups (56.7% and 64.0%, respectively)., Conclusions: Family assisted alarm therapy and self-responsible alarm therapy are equally efficacious in the treatment of childhood nocturnal enuresis., (Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)