Efficacy and Safety of Vitamin D Supplementation Combined With Alarm Therapy in Treating Nocturnal Enuresis: A Prospective, Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 262
- 试验地点
- 1
- 主要终点
- Change in enuresis frequency
研究概览
简要总结
This prospective, randomized, two-arm, parallel-design controlled clinical trial aims to determine whether high-dose vitamin D supplementation combined with alarm therapy improves outcomes in children with primary monosymptomatic nocturnal enuresis compared to alarm therapy alone.
详细描述
Nocturnal enuresis (NE) is characterized by recurrent involuntary urination during sleep in children aged 5 years and older, persisting for over three months with at least two episodes per week. This condition, resulting from the child's inability to awaken from sleep, exhibits a prevalence rate ranging from 4.8% to 15.2%, which notably declines with age. Moreover, NE significantly impacts the psychological well-being and overall quality of life of affected individuals. The primary treatments for NE include desmopressin acetate (DDAVP) and behavioral interventions (BI). While these modalities offer therapeutic benefits, their implementation is often prolonged and fraught with challenges, including adverse drug reactions and a high rate of symptom recurrence after treatment discontinuation. These factors complicate adherence for both patients and their families.
Patients with NE are more likely to suffer from vitamin D deficiency. This study aims to determine the effect of vitamin D supplementation as an adjunctive therapy to alarm therapy in the treatment of primary monosymptomatic nocturnal enuresis(PMNE). Eligible patients aged 5-18 years with a diagnosis of NE will be randomly assigned to receive either high-dose vitamin D supplementation combined with alarm therapy or alarm therapy alone. Serum levels of 25(OH)D will be measured at baseline. Symptom severity will be assessed at baseline and follow-up, along with other sociodemographic data. This study will provide more information on the role of vitamin D supplementation in managing PMNE.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 5 Years 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Children aged 5-18 years diagnosed with PMNE-defined as intermittent urinary incontinence during sleep in a children who are never dry for more than 6 months and have no other lower urinary tract symptoms-according to the latest International Children's Continence Society guidelines, presenting at outpatient urology clinics.
- •Serum vitamin D level below 30 ng/mL.
- •Written informed consent obtained from each participant and their guardian.
- •Adequate psychological and cognitive function, no communication barriers, and ability to accurately report symptoms and potential adverse reactions during treatment.
排除标准
- •Urological malformations or serious urological disease, such as hypospadias, cryptorchidism, posterior urethral valves, vesicoureteral reflux, neurogenic bladder, urinary tumors, urinary stones, or bladder/urethral injuries.
- •Neurological disorders, including epilepsy, spinal cord injury or dysplasia, spinal embolism syndrome, multiple sclerosis, autism spectrum disorder, or attention-deficit/hyperactivity disorder.
- •Endocrine diseases, such as diabetes mellitus or hyperthyroidism.
- •Severe systemic disease, including significant cardiac disease, renal or hepatic insufficiency, pulmonary disease, bone deformities, gastrointestinal disorders, or inherited metabolic disorders.
- •Conditions predisposing to sleep apnea, such as adenoid or tonsillar hypertrophy, deviated nasal septum, craniofacial abnormalities, or central sleep apnea.
- •History of gastrointestinal or urological surgery.
- •Use of anticonvulsant, antiepileptic, corticosteroid, or anti-tuberculosis medications.
- •History of hypercalcemia, hyperphosphatemia, or renal rickets.
- •Unexplained hematuria or urinary tract infection within the past year.
- •Allergy to vitamin D formulations.
- •Concurrent participation in other clinical studies.
- •Unwillingness to participate or poor anticipated follow-up compliance.
研究组 & 干预措施
Alarm therapy
These patients will receive alarm therapy for 8 weeks
干预措施: alarm therapy (Behavioral)
Alarm therapy combined with short-term high dose exogenous vitamin D supplementation
These patients will receive high-dose vitamin D supplementation (more than 2000IU daily) and alarm therapy for 8 weeks
干预措施: alarm therapy (Behavioral)
Alarm therapy combined with short-term high dose exogenous vitamin D supplementation
These patients will receive high-dose vitamin D supplementation (more than 2000IU daily) and alarm therapy for 8 weeks
干预措施: Vitamin D3 (Drug)
结局指标
主要结局
Change in enuresis frequency
时间窗: 8 week
Change in enuresis frequency from baseline to follow-up
Response after interventions
时间窗: 8 weeks
Response rate: defined as a ≥50% reduction in the number of wet nights per week
Complete response after interventions
时间窗: 8 weeks
The rate of complete response was defined as a 100% reduction in wet nights per week.
次要结局
- Change in quality of life score(8 week)
- Change in vitamin D level(8 week)
- Change in serum levels of calcium(8 weeks)
- Global perception of improvement(8 week)
- Wish to receive another form of treatment?(8 week)
- Treatment adherence(8 week)
- Incidence of side effects(8 week)
- Change in enuresis frequency(8 weeks)
研究者
Xing Liu
Professor, Doctor
Children's Hospital of Chongqing Medical University