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Study details efficacy of coaching to increase water intake on kidney function among patients with CKD
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Coaching adults with chronic kidney disease to increase water intake did not significantly slow the decline in kidney function at 1-year follow-up, according to randomized clinical trial results that will appear in JAMA.
“The take-away message is 1, patients with progressive stage 3 [chronic kidney disease] CKD can safely increase their level of hydration on average by three glasses of water per day without adverse effects [and] 2, this increase in hydration results in a significant suppression in anti-diuretic hormone but it is not associated with a measurable slowing in loss of kidney function as measured by change in [estimated glomerular filtration rate] (eGFR) over 1 year,” lead author William F. Clark, MD, of the London Health Sciences Center in Ontario, told Healio Nephrology.
Researchers conducted a clinical trial in nine centers in Ontario, Canada of 631 randomized patients. Patients were categorized into a hydration group that was coached to drink more water and a control group that was coached to maintain patients’ usual intake.
Of the 631 patients, 12 died. For the 590 survivors with 1-year follow-up measurements, investigators found the mean change in 24-hour urine volume was 0.6 L per day greater in the hydration group. The mean change in eGFR was -2.2 mL/min/1.73m2 in the hydration group and was -1.9mL/min/1.732 in the control group.
The study noted that the absence of an effect of drinking more water on eGFR may be in several ways. Investigators noted increased water intake may not protect against declining kidney function, and prior studies may have been confounded. In addition, the study may have been underpowered and therefore could not identify an effect as statistically significant. Although the hydration group achieved an increased fluid intake and decreased copeptin concentration, a greater difference in water intake may be needed to produce a measurable effect on eGFR. Lastly, follow-ups may have to be conducted more than 1 year after the baseline to detect an effect on eGFR. – by Jake Scott
Disclosures: Clark reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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