Prescribed Water Intake in Autosomal Dominant Polycystic Kidney Disease
Rangan GK, Wong ATY, Munt A, Zhang JQJ, Saravanabavan S, Louw S, Allman-Farinelli M, Badve SV, Boudville N, Chan J, Coolican H, Coulshed S, Edwards ME, Erickson BJ, Fernando M, Foster S, Gregory AV, Haloob I, Hawley CM, Holt J, Howard K, Howell M, Johnson DW, Kline TL, Kumar K, Lee VW, Lonergan M, Mai J, McCloud P, Pascoe E, Peduto A, Rangan A, Roger SD, Sherfan J, Sud K, Torres VE, Vilayur E, Harris DCH
NEJM evidence · 47 citas
Etiquetas de revisión
Financiación no declaradaDatos 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
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2021-12-21 · NEJM Evid · vol. 1 · número 1 · pág. EVIDoa2100021
- Citado
- 57 citas · más que el 97% de estudios similares · 5.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 39 trabajos
- Acceso
- De pago
- Áreas de investigación
- Genetic and Kidney Cyst Diseases · Pediatric Urology and Nephrology Studies · Renal and related cancers
- Palabras clave
- Urine osmolality, Medicine, Autosomal dominant polycystic kidney disease, Renal function, Urine, Vasopressin, Kidney disease, Urine specific gravity, Confidence interval, Internal medicine, Kidney, Plasma osmolality, Urology, Polycystic kidney disease, Endocrinology, Animal science, Biology
- MeSH
- kidney, humans, polycystic kidney, autosomal dominant, drinking, adult, middle aged, female, male
38 autores
- Gopala K. Rangan🇦🇺The University of Sydney; Westmead Hospital; Sydney Local Health District; Westmead Institute for Medical Research; Western Sydney Local Health District
- Annette T. Y. Wong🇦🇺The University of Sydney; Westmead Hospital; Sydney Local Health District; Westmead Institute for Medical Research; Western Sydney Local Health District
- Alexandra Munt🇦🇺The University of Sydney; Westmead Hospital; Sydney Local Health District; Westmead Institute for Medical Research; Western Sydney Local Health District
- Jennifer Q. J. Zhang🇦🇺The University of Sydney; Westmead Hospital; Sydney Local Health District; Westmead Institute for Medical Research; Western Sydney Local Health District
- Sayanthooran Saravanabavan🇦🇺The University of Sydney; Westmead Hospital; Sydney Local Health District; Westmead Institute for Medical Research; Western Sydney Local Health District
- Sandra Louw
- Margaret A Allman-Farinelli🇦🇺The University of Sydney
- Sunil V. Badve🇦🇺UNSW Sydney; The George Institute for Global Health; St George Hospital
- Neil C Boudville🇦🇺The University of Western Australia; Sir Charles Gairdner Hospital
- Jessie S. M. Chan
- Helen Coolican
- Susan Coulshed
- Marie E. Edwards🇺🇸Mayo Clinic
- Bradley James Erickson🇺🇸Mayo Clinic
- Mangalee R. Fernando🇦🇺Prince of Wales Hospital; South Eastern Sydney Local Health District
- Sheryl Foster🇦🇺The University of Sydney; Westmead Hospital; Sydney Local Health District; Western Sydney Local Health District
- Adriana Gregory🇺🇸Mayo Clinic
- Imad Adbi Haloob
- Carmel Mary Hawley🇦🇺The University of Queensland; Princess Alexandra Hospital
- Jane L. Holt🇦🇺Wollongong Hospital; Illawarra Shoalhaven Local Health District
- Kirsten Howard🇦🇺The University of Sydney
- Martin Howell🇦🇺The University of Sydney
- David Wayne Johnson🇦🇺The University of Queensland; Princess Alexandra Hospital
- Timothy L. Kline🇺🇸Mayo Clinic
- Karthik Kumar🇦🇺Gosford Hospital
- Vincent W. Lee🇦🇺The University of Sydney; Westmead Hospital; Sydney Local Health District; Westmead Institute for Medical Research; Western Sydney Local Health District
- Maureen Lonergan🇦🇺Wollongong Hospital; Illawarra Shoalhaven Local Health District
- Jun Mai🇦🇺Liverpool Hospital; Sydney Local Health District
- Philip McCloud
- Elaine Pascoe🇦🇺The University of Queensland; Princess Alexandra Hospital
- Anthony J. Peduto🇦🇺Westmead Hospital; Sydney Local Health District; Western Sydney Local Health District
- Anna Rangan🇦🇺The University of Sydney
- Simon D. Roger🇦🇺Gosford Hospital
- Julie Sherfan🇦🇺Royal Prince Alfred Hospital
- Kamal Sud🇦🇺The University of Sydney; Nepean Hospital; Westmead Hospital; Sydney Local Health District; Western Sydney Local Health District
- Vicente E. Torres🇺🇸Mayo Clinic
- Eswari Vilayur🇦🇺John Hunter Hospital
- David C.H. Harris🇦🇺The University of Sydney; Westmead Hospital; Sydney Local Health District; Westmead Institute for Medical Research; Western Sydney Local Health District
Resumen
El texto original del estudio, en el idioma en que se publicó.
BACKGROUND: Arginine vasopressin promotes kidney cyst growth in autosomal dominant polycystic kidney disease (ADPKD). Increased water intake reduces arginine vasopressin and urine osmolality and may slow kidney cyst growth. METHODS: In this randomized controlled 3-year clinical trial, we randomly assigned adults with ADPKD who had a height-corrected total kidney volume in Mayo imaging subclass categories 1B to 1E and an estimated glomerular filtration rate of 30 ml/min/1.73 m2 or greater to (1) water intake prescribed to reduce 24-hour urine osmolality to 270 mOsmol/kg or less or (2) ad libitum water intake irrespective of 24-hour urine osmolality. The primary end point was the percentage annualized rate of change in height-corrected total kidney volume. RESULTS: A total of 184 patients participated in either the ad libitum water intake group (n=92) or the prescribed water intake group (n=92). Over 3 years, there was no difference in the annualized rate of change in height-corrected total kidney volume between the ad libitum (7.8% per year; 95% confidence interval [CI], 6.6 to 9.0) and prescribed (6.8% per year; 95% CI, 5.8 to 7.7) water intake groups (mean difference, −0.97% per year; 95% CI, −2.37 to 0.44; P=0.18). The difference in mean 24-hour urine osmolality between the ad libitum and prescribed water intake groups was −91 mOsmol/kg (95% CI, −127 to −54 mOsmol/kg), with 52.3% of patients achieving adherence to the target 24-hour urine osmolality and no reduction in serum copeptin over 3 years. The frequency of adverse events was similar between groups. CONCLUSIONS: For patients with ADPKD, prescribed water intake was not associated with excess adverse events and achieved the target 24-hour urine osmolality for half of the patients but did not reduce copeptin or slow the growth of total kidney volume over 3 years compared with ad libitum water intake. (Funded by the National Health and Medical Research Council of Australia [grant GNT1138533], Danone Research, PKD Australia, the University of Sydney, and the Westmead Medical Research Foundation; Australian New Zealand Clinical Trials Registry number, ACTRN12614001216606).
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