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Letter to the Editor

Dr Fefferman points out one of the unanswered questions regarding vasopressin and nocturnal enuresis—the issue of whether the low morning urine osmolalities and flat ADH secretion pattern that have been reported1-3 can somehow be related to excessive water intake. As a clinician, I have always had the impression that many children with nocturnal enuresis do drink a lot, but it is exceedingly difficult to get accurate measurements. I have always wondered whether the patterns reported could be due to some sort of washout of the osmoregulating system due to a chronically excessive intake of water.