title: The chronic kidney disease Water Intake Trial (WIT): results from the pilot randomised controlled trial.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  (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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: William F
authors.initials: WF
authors.lastname: Clark
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Sontrop
authors.forename: Shih-Han
authors.initials: SH
authors.lastname: Huang
authors.forename: Kerri
authors.initials: K
authors.lastname: Gallo
authors.forename: Louise
authors.initials: L
authors.lastname: Moist
authors.forename: Andrew A
authors.initials: AA
authors.lastname: House
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Weir
authors.forename: Amit X
authors.initials: AX
authors.lastname: Garg
keywords: EPIDEMIOLOGY; INTERNAL MEDICINE