School of Molecular Bioscience, Charles Perkins Centre, The University of Sydney, Sydney, Australia.
Centre for Transplant and Renal Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia.
Nephrology (Carlton). 2016 Oct;21(10):860-9. doi: 10.1111/nep.12675.
Maintaining adequate fluid intake has been hypothesized to be beneficial for the progression of chronic kidney disease (CKD). The aim of this study was to undertake a systematic review to determine the most effective interventions to increase water intake.
Six electronic databases were searched from 1910 until March 2015 in the English language. Additional sources through hand-searches, expert recommendations and reviews were checked. Intervention studies increasing water intake in adults through non-pharmacological methods were eligible for inclusion. The quality of included studies was assessed.
A total of 950 studies were found of which 16 met the inclusion criteria. Eight studies were randomized controlled trials, and seven studies spanned 6 months or longer. The study populations varied and included patients with recurrent nephrolithiasis (n = 6), autosomal dominant polycystic kidney disease (n = 3), CKD (n = 1), urinary tract infection (n = 1) and other miscellaneous conditions (n = 5). The quality of the studies was mostly neutral (63%) with no studies of high quality. Interventions ranged from instruction alone to self-monitoring tools, providing water bottles and counselling and education. Most interventions successfully increased water intake with 13 studies reporting an increase of at least 500 mL. The most effective strategies were instruction and self-monitoring using urine dipstick or 24 h urine volume.
All interventions carried out in the studies succeeded in increasing water intake, with none leading to decreases in intake, and these could be implemented in potential clinical trials in CKD. However, more high quality long-term intervention studies are required to further validate findings.
维持足够的液体摄入被认为有益于慢性肾脏病（CKD）的进展。本研究旨在进行系统评价，以确定增加水摄入的最有效干预措施。
从 1910 年到 2015 年 3 月，我们在英语环境下搜索了 6 个电子数据库。通过手工搜索、专家推荐和综述检查了其他来源。纳入了通过非药物方法增加成年人水摄入的干预研究。评估了纳入研究的质量。
共发现 950 项研究，其中 16 项符合纳入标准。8 项研究为随机对照试验，7 项研究持续 6 个月或更长时间。研究人群各不相同，包括复发性肾结石患者（n=6）、常染色体显性多囊肾病患者（n=3）、CKD 患者（n=1）、尿路感染患者（n=1）和其他杂项疾病患者（n=5）。研究质量大多为中性（63%），没有高质量的研究。干预措施范围从单独指导到自我监测工具、提供水瓶以及咨询和教育。大多数干预措施成功地增加了水的摄入，其中 13 项研究报告至少增加了 500ml。最有效的策略是使用尿试纸或 24 小时尿液量进行指导和自我监测。
所有研究中实施的干预措施都成功地增加了水的摄入，没有一项导致摄入减少，这些措施可以在 CKD 的潜在临床试验中实施。然而，需要更多高质量的长期干预研究来进一步验证研究结果。
