Urine volume and change in estimated GFR in a community-based Cohort study

The message to drink “at least 8 glasses
of water a day” is widespread despite a
lack of evidence to support this claim.
There is sample experimental evidence in
rats to suggest that fluid loading slows
the progress of renal impairment and one
recent article (MDRD Study) in patients
with advanced kidney failure that
suggests the reverse. We wished to study
the effect of increased fluid intake on
kidney function by evaluating the
relationship between urine volume and
renal decline over six years in a large
community-based cohort. The prospective
cohort study was undertaken in Canada
from 2002 to 2008 and we obtained
24-hour (validated by urine creatinine)
samples from adult participants with
estimated GFR (eGFR) of greater than 60
l/min/1.73m2 at study entry. Percentage
annual change in eGFR from baseline was
categorized as an average decline (less
than 1 percent per year), between 1% and
4.9% (mild to moderate decline) or
greater than 5% (rapid decline).
Additionally, to ensure accurate
assessment of fluid intake, participants
were screened for the presence of
synthetic urine samples,
which could potentially skew the

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Last modified on Friday, 28 March 2014

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