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Urine Concentration and Enuresis in Healthy Preschool Children-Reply

Robert A. Mevorach, MD; Guy A. Bogaert, MD; Barry A. Kogan, MD
Arch Pediatr Adolesc Med. 1995;149(12):1400-1401. doi:10.1001/archpedi.1995.02170250106022.
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We agree with Drs Robson and Leung that data regarding the pathogenesis of nocturnal enuresis are inconclusive and that the mechanism by which desmopressin acetate (DDAVP) is effective for treatment of the condition is unclear. We find the data reported by Evans and Meadow1 to be interesting; however, their article does not convince us that children who concentrate their urine will benefit from desmopressin. Of the responders (defined as patients with an improvement of two or more dry nights per week—not an impressive difference!), the mean pretreatment urine osmolality was 506 mmol/kg, with a single patient having a value of 1053 mmol/kg. Furthermore, we do not know how well that one patient responded—perhaps only two dry nights per week, a difference that could be explained by many things other than the medication. We find the results reported by Dimson2 to be interesting also. Several patients who concentrated their

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