Does increased water intake prevent disease progression in autosomal dominant polycystic kidney disease?

Abstract

BACKGROUND:

The clinical effects of increased water intake on autosomal dominant polycystic kidney disease (ADPKD) progression are unknown.

METHODS:

ADPKD patients with creatinine clearance ≧ 50 mL/min/1.73 m(2) were divided into high (H-, n = 18) and free (F-, n = 16) water-intake groups, mainly according to their preference. Prior to the study, 30 patients underwent annual evaluation of total kidney volume (TKV) and 24-h urine for an average of 33 months. During the 1-year study period, TKV and 24-h urine were analyzed at the beginning and end of the study and every 4 months, respectively.

RESULTS:

During the pre-study period, urine volume (UV) in the H-group was higher (P = 0.034), but TKV and kidney function and their slopes were not significantly different between the two groups. After the study commenced, UV further increased (P < 0.001) in the H-group but not in the F-group. During the study period, TKV and kidney function slopes were not significantly different between the two groups (primary endpoint). Plasma copeptin was lower (P = 0.024) in the H-group than in the F-group. TKV and kidney function slopes became worse (P = 0.047 and 0.011, respectively) after high water intake (H-group) but not in the F-group. High UV was associated with increased urine sodium, and urine sodium positively correlated with the % TKV slope (P = 0.014).

CONCLUSIONS:

Although the main endpoint was not significant, high water intake enhanced disease progression in the H-group when compared with the pre-study period. These findings necessitate a long-term randomized study before drawing a final conclusion.

• Authors: Eiji Higashihara, Kikuo Nutahara, Mitsuhiro Tanbo, Hidehiko Hara, Isao Miyazaki, Kuninori Kobayashi, Toshiaki Nitatori
• Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant) Vol. 29 Issue 9 Pg. 1710-9 (Sep 2014) ISSN: 1460-2385 [Electronic] England
• PMID: 24739484 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA.

Chemical References

• Glycopeptides
• copeptins

Topics

• Adult
• Blood Pressure
• Disease Progression
• Drinking
• Female
• Glomerular Filtration Rate
• Glycopeptides (blood)
• Humans
• Kidney (pathology, physiopathology)
• Male
• Middle Aged
• Organ Size
• Polycystic Kidney, Autosomal Dominant (blood, pathology, physiopathology)
• Young Adult