Nocturnal enuresis in children with sickle-cell anemia: global prevalence rates, gender bias and hypotheses on pathogenesis
Abstract
Nocturnal enuresis is a prevalent disorder in children and young adults with sickle-cell anemia (SCA): the most common hemoglobinopathy affecting the Negroid population worldwide. Hyposthenuria is one of the earliest renal defects in the disease, but its role as the exclusive causal factor of nocturnal enuresis in SCA still remains debatable as it appears the etiology of nocturnal enuresis is multifactorial in affected children. Interestingly, studies that have elucidated the epidemiologic perspectives of enuresis in SCA have equally shown inconsistent findings regarding for instance, gender predominance and the impact of socio-economic status. This narrative review therefore aims to appraise the multi-regional studies which have reported the prevalence rates, gender bias and determinants of nocturnal enuresis in these children.
Although children with SCA show a tendency to develop nocturnal enuresis more than their non-SCA counterparts with a male predominance, the exact etio-pathogenesis is not completely understood. Possible mechanisms that underlie nocturnal enuresis in subjects with normal hemoglobin genotype appear to be applicable in individuals with SCA. The multi-regional variations in prevalence rates of nocturnal enuresis in SCA patients are due to differences in study definition criteria and methodology. Perhaps, adopting standardized definitions and study methods may in future minimize the disparities in the reported figures. Further research is still required to elucidate the exact pathogenesis of nocturnal enuresis in SCA.
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DOI: http://dx.doi.org/10.18103/imr.v0i5.119
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