title: Association between fluid intake and kidney function, and survival outcomes analysis: a nationwide population-based study.
abstract: Fluid intake, one of the most common daily activities, has not been well studied in chronic kidney disease (CKD) populations, and clinical outcomes are rarely addressed. The aim of this nationwide study is to explore the influence of daily fluid intake on cardiovascular and all-cause mortality and its association with renal function.
  
  
  
  Observational cohort study.
  
  
  
  In all, 2182 participants aged more than 20 years participated in the Third National Health and Nutrition Examination Survey (1988-1994).
  
  
  
  Survival outcomes in patients with or without CKD, using multiple variable adjusted Cox proportional hazard models.
  
  
  
  In a longitudinal survey with a median follow-up length of 15.4 years, 1080 participants died and 473 cardiovascular deaths were recorded. For all-cause mortality in the CKD group, individuals in the highest quartile of fluid intake (≧3.576 L/day) had better survival outcomes than those in the lowest quartile of fluid intake (≤2.147 L/day) (p=0.029) after adjustment of several pertinent variables.
  
  
  
  Although the interpretation of this observational study was limited by the failure to identify the compositions of ingested fluids, adequate hydration may offer some advantages in patients with CKD. However, the underlying pathophysiological mechanisms of the responses of normal and injured kidneys to chronic changes in fluid consumption warrant further investigation.
authors.affiliation: Division of Family Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan (ROC) Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan (ROC) Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (ROC).
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Wu
authors.affiliation: Division of Family Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan (ROC) Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan (ROC) Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (ROC).
authors.forename: Wei-Liang
authors.initials: WL
authors.lastname: Chen
authors.affiliation: Division of Family Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan (ROC).
authors.forename: Fang-Yih
authors.initials: FY
authors.lastname: Liaw
authors.affiliation: Division of Family Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan (ROC).
authors.forename: Yu-Shan
authors.initials: YS
authors.lastname: Sun
authors.affiliation: Division of Family Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan (ROC).
authors.forename: Hui-Fang
authors.initials: HF
authors.lastname: Yang
authors.affiliation: Division of Family Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan (ROC).
authors.forename: Chung-Ching
authors.initials: CC
authors.lastname: Wang
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (ROC).
authors.forename: Chien-Ming
authors.initials: CM
authors.lastname: Lin
authors.affiliation: Division of Nephrology, Department of Medicine, Taoyuan General Hospital, Taoyuan City, Taiwan (ROC) Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan (ROC).
authors.forename: Yu-Tzu
authors.initials: YT
authors.lastname: Tsao
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D016022:Case-Control Studies; D002423:Cause of Death; D004326:Drinking; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*; D015996:Survival Rate; D014481:United States / Q000453:epidemiology
keywords: all-cause mortality; cardiovascular mortality; fluid intake