Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada.
BMJ Open. 2013 Dec 20;3(12):e003666. doi: 10.1136/bmjopen-2013-003666.
Increased water intake may benefit kidney function. Prior to initiating a larger randomised controlled trial (RCT), we examined the safety and feasibility of asking adults with chronic kidney disease (CKD) to increase their water intake.
DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: Beginning in October 2012, we randomly assigned 29 adults with stage 3 CKD (estimated glomerular filtration rate (eGFR) 30-60 mL/min/1.73 m(2) and albuminuria) to one of the two groups of water intake: hydration (n=18) or standard (n=11). We asked the hydration group to increase their water intake by 1.0-1.5 L/day (in addition to usual intake, depending on sex and weight) for 6 weeks, while the control group carried on with their usual intake. Participants collected a 24 h urine sample at baseline and at 2 and 6 weeks after randomisation. Our primary outcome was the between-group difference in change in 24 h urine volume from baseline to 6 weeks.
(63%)of participants were men, 81% were Caucasians and the average age was 61 years (SD 14 years). The average baseline eGFR was 40 mL/min/1.73 m(2) (SD 11 mL/min/1.73 m(2)); the median albumin to creatinine ratio was 19 mg/mmol (IQR 6-74 mg/mmol). Between baseline and 6-week follow-up, the hydration group's average 24 h urine volume increased by 0.7 L/day (from 2.3 to 3.0 L/day) and the control group's 24 h urine decreased by 0.3 L/day (from 2.0 to 1.7 L/day; between-group difference in change: 0.9 L/day (95% CI 0.4 to 1.5; p=0.002)). We found no significant changes in urine, serum osmolality or electrolyte concentrations, or eGFR. No serious adverse events or changes in quality of life were reported.
A pilot RCT indicates adults with stage 3 CKD can successfully and safely increase water intake by up to 0.7 L/day in addition to usual fluid intake. TRIAL REGISTRATION REGISTERED WITH CLINICAL TRIALSGOVERNMENT IDENTIFIER: NCT01753466.
增加水的摄入量可能有益于肾脏功能。在启动更大规模的随机对照试验（RCT）之前，我们研究了让患有慢性肾脏病（CKD）的成年人增加水摄入量的安全性和可行性。
设计、地点、参与者和测量：从 2012 年 10 月开始，我们将 29 名患有 3 期 CKD（估算肾小球滤过率（eGFR）为 30-60mL/min/1.73m(2)和蛋白尿）的成年人随机分配到两组水摄入组中的一组：水合（n=18）或标准（n=11）。我们要求水合组每天增加 1.0-1.5L 的水摄入（根据性别和体重而定，除了通常的摄入量之外），持续 6 周，而对照组则继续进行常规摄入。参与者在基线和随机分组后 2 周和 6 周收集 24 小时尿液样本。我们的主要结果是从基线到 6 周时 24 小时尿液量的组间变化差异。
（63%）的参与者为男性，81%为白种人，平均年龄为 61 岁（SD 14 岁）。平均基线 eGFR 为 40mL/min/1.73m(2)（SD 11mL/min/1.73m(2)）；中位白蛋白/肌酐比值为 19mg/mmol（IQR 6-74mg/mmol）。在基线和 6 周随访期间，水合组的平均 24 小时尿量每天增加 0.7L（从 2.3 到 3.0L/天），对照组的 24 小时尿量每天减少 0.3L（从 2.0 到 1.7L/天；组间变化差异：0.9L/天（95%CI 0.4 到 1.5；p=0.002））。我们没有发现尿液、血清渗透压或电解质浓度或 eGFR 的显著变化。没有报告严重不良事件或生活质量的变化。
一项试点 RCT 表明，患有 3 期 CKD 的成年人可以在常规液体摄入之外成功且安全地每天增加多达 0.7L 的水摄入。
临床试验.gov 标识符：NCT01753466。
