[Medical Q&A] Does frequent urination at night in the elderly mean that their kidneys are not in good condition?

Planner: Chinese Medical Association

Reviewer: Li Mingxi, Chief Physician, Peking Union Medical College Hospital

Increased nocturia can be caused by urinary or non-urinary diseases. Many elderly people worry that there is something wrong with their kidneys, but this is not the case. Age-related physiological structure, hormones, and histological changes are important factors in the increase in nocturia in the elderly. Studies have shown that the most common causes of increased nocturia in men are urinary urgency, prostate hyperplasia, and snoring, followed by prostate cancer and taking antidepressants; and urinary urgency, obesity, and snoring in women, followed by coronary heart disease and diabetes.

For prostate hyperplasia, the most common disease in middle-aged and elderly patients, when bladder irritation symptoms occur, such as urinary urgency, frequent urination, urge incontinence, increased nocturia, etc., or obstructive symptoms caused by urinary tract obstruction, such as labored urination, thinning urine stream, and dribbling urine, etc., it is necessary to go to the hospital in time for urine routine and B-ultrasound examinations to further clarify the cause. For mild and moderate patients, regular follow-up should be carried out, and if necessary, medication should be taken under the guidance of a doctor to control symptoms. Severe patients require surgical treatment.

Patients with urinary tract infections, such as cystitis and pyelonephritis, need timely drug treatment; some internal medicine diseases, such as diabetes, diabetes insipidus, and primary aldosteronism, require drug treatment and close observation; when you suffer from hypertension, heart disease, heart failure, etc., you often need to take diuretics, which can easily cause increased nocturia. In addition to observing urine volume and urine color, you must be alert to the adverse reactions of diuretics; some physiological factors, such as uterine prolapse in elderly women, relaxation of tissue around the bladder neck, and bladder prolapse, cause frequent urination at night and require certain rehabilitation exercises.

In short, don't take it for granted that increased nocturia is a normal phenomenon of natural aging in the elderly and does not pose a major threat to health, and thus ignore examination and treatment. Correctly understanding the potential disease risks of increased nocturia is the best way to avoid disease progression.