title: 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.affiliation: Department of ADPKD Research, Kyorin University School of Medicine, Tokyo, Japan Department of Urology, Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Higashihara
authors.affiliation: Department of Urology, Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Kikuo
authors.initials: K
authors.lastname: Nutahara
authors.affiliation: Department of Urology, Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Tanbo
authors.affiliation: Department of Urology, Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Hara
authors.affiliation: Department of Radiology, Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Miyazaki
authors.affiliation: Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University, Tokyo, Japan.
authors.forename: Kuninori
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Department of Radiology, Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Nitatori
mesh_terms: D000328:Adult; D001794:Blood Pressure; D018450:Disease Progression; D004326:Drinking; D005260:Female; D005919:Glomerular Filtration Rate; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D016891:Polycystic Kidney, Autosomal Dominant / Q000097:blood / Q000473:pathology* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D006020:Glycopeptides; C048197:copeptins
keywords: autosomal dominant polycystic kidney disease; glomerular filtration rate; kidney volume; urine volume; vasopressin
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