Financiado en parte por Mitsubishi Tanabe Pharma Corporation
Low-Osmolar Diet and Adjusted Water Intake for Vasopressin Reduction in Autosomal Dominant Polycystic Kidney Disease: A Pilot Randomized Controlled Trial
Amro OW, Paulus JK, Noubary F, Perrone RD
American journal of kidney diseases : the official journal of the National Kidney Foundation · 48 citas
Etiquetas de revisión
Financiado por la industriaSolo mecanismosDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Solo mecanismos
Quién lo pagó
- Financiación
- Financiado por la industria
- Empresa
- Mitsubishi Tanabe Pharma Corporation
- Gobierno
- National Institutes of Health
- Gobierno
- National Institute on Aging
- Gobierno
- National Institute of Diabetes and Digestive and Kidney Diseases
- Gobierno
- National Center for Advancing Translational Sciences
- Gobierno
- NCATS NIH HHS
- Gobierno
- National Center for Advancing Translational Sciences, NIH
- Gobierno
- NIDDK NIH HHS
- Subvenciones
- National Center for Advancing Translational Sciences (UL1-TR-001064); National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007777)
Según 8 financiadores declarados.
Publicación
- Publicado
- 2016-09-20 · Am J Kidney Dis · vol. 68 · número 6 · págs. 882–891
- Editorial
- Elsevier BV
- Citado
- 63 citas · más que el 96% de estudios similares · 5.9× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 34 trabajos
- Acceso
- Acceso abierto (copia en repositorio)
- Áreas de investigación
- Genetic and Kidney Cyst Diseases · Electrolyte and hormonal disorders · Ion Transport and Channel Regulation
- Palabras clave
- autosomal dominant polycystic kidney disease, vasopressin, sodium restriction, low-protein diet, water intake, urine osmolality, copeptin, disease progression, dietary intervention, fluid restriction, proteinuria, albuminuria, blood pressure
- MeSH
- humans, polycystic kidney, autosomal dominant, pilot projects, drinking, osmolar concentration, adolescent, adult, middle aged, female, male, arginine vasopressin, young adult
4 autores
- Osama W. Amro🇺🇸Tufts University; Tufts Medical Center
- Jessica K. Paulus🇺🇸Tufts University; Tufts Medical Center
- Farzad Noubary🇺🇸Tufts University; Tufts Medical Center
- Ronald D. Perrone🇺🇸 · autor de correspondenciaTufts University; Tufts Medical Center
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Autosomal dominant polycystic kidney disease (ADPKD) affects millions of people worldwide. Vasopressin promotes disease progression.
Study design
A randomized controlled trial with equal (1:1) allocation.
Setting & participants
This trial examined the effect of combining a low-osmolar (low-sodium [1,500mg/d], low-protein [0.8g per kilogram of body weight]) diet and adjusted water intake on vasopressin secretion in 34 patients with ADPKD.
Intervention
Participants were randomly assigned to receive a low-osmolar diet followed by adjusted water intake to achieve urine osmolality ≤ 280mOsm/kg water versus no intervention for 2 weeks.
Outcome
The primary outcome of the study was change (delta) in copeptin levels and urine osmolality between the intervention and control groups from baseline to 2 weeks.
Measurements
Fasting plasma copeptin level, 24-hour urine osmolality, and total solute intake.
Results
Baseline characteristics of the 2 groups were similar. Mean plasma copeptin levels and urine osmolality declined from 6.2±3.05 (SD) to 5.3±2.5pmol/L (P=0.02) and from 426±193 to 258±117mOsm/kg water (P=0.01), respectively, in the intervention group compared to a nonsignificant change in the control group (from 4.7±3.6 to 5.07±4pmol/L [P=0.2] and 329±159 to 349±139mOsm/kg water [P=0.3], respectively). The change in copeptin levels (primary outcome) and urine osmolality was statistically significant between the intervention and control groups (delta copeptin, -0.86±1.3 vs +0.39±1.2pmol/L [P=0.009]; delta urine osmolality, -167±264 vs +20±80mOsm/kg water [P=0.007], respectively). Total urinary solute decreased in only the intervention group and significantly differed between groups at week 1 (P=0.03), reducing mean water prescription from 3.2 to 2.6L/d.
Limitations
Small sample size and short follow-up.
Conclusions
We developed a stepwise dietary intervention that led to a significant reduction in vasopressin secretion in patients with ADPKD. Furthermore, this intervention led to a reduction in water required for vasopressin reduction.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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