Drinking more water does not slow decline of kidney function for kidney disease patients

May 8, 2018, Lawson Health Research Institute
Credit: CC0 Public Domain

A new study, published in JAMA (Journal of the American Medical Association) by researchers at Lawson Health Research Institute and Western University, found that coaching patients with Chronic Kidney Disease (CKD) to drink more water does not slow down the decline of their kidney function.

"Despite widespread beliefs, little scientific data exists on the optimal amount of to drink," explains Dr. William Clark, Scientist at Lawson and Professor at Western's Schulich School of Medicine & Dentistry. "While many claims about the benefits of increased water intake remain untested, a growing body of evidence suggests that increased water intake improves through the suppression of the antidiuretic hormone."

This leads to the question of whether increased water intake can slow the progressive loss of function.

Guided by a successful pilot study, the research team constructed a randomized clinical trial with patients at London Health Sciences Centre (LHSC) and several other hospitals in Ontario. They wanted to determine if coaching patients to drink more water slowed their decline in kidney function over one year compared with those in the control group who were coached to maintain usual fluid intake.

"It is really about personalized medicine," says Dr. Clark who is the principal investigator for the study and Director of Apheresis and Consultant Nephrologist at LHSC. "Could we look at the general population of patients with kidney disease and find that increased water intake helps slow the decline in function? And if not, how can we apply this knowledge to create more targeted treatment approaches?"

The trial is the largest to date with over 630 participants with Stage 3 CKD. The cause of their disease was varied, including diabetes and high blood pressure.

"Those diagnosed with CKD have some degree of kidney damage, indicated by a decreased level of kidney function," explains Kerri Gallo, RN Project Manager for the study. "Kidney disease can range from mild to severe and, in some cases, leads to kidney failure. Kidney disease often starts slowly and develops without symptoms over a number of years, so it may not be detected until it has progressed to the point where kidney function is quite low."

Most patients with Stage 3 CKD experience either no symptoms or only mild effects, but they have already lost over 40 to 70 per cent of kidney function.

"Current treatment guidelines are very limited for these patients. It includes the use of medication and optimal blood pressure control including salt restriction and increased water intake," notes Gallo. "We have no way to actively stop the decline or regain function. Our efforts right now are to slow the progress."

The research team found that after one year, the increase of water did not slow the loss of kidney function. They did find that an increase of water, particularly when the participant's previous intake was low, did significantly suppress their antidiuretic hormone release. The prior benefits shown for water intake may relate to low water drinkers in the population.

"This research indicates that for most patients with CKD, increasing fluid intake will not stop further loss of kidney . It does allow us then to focus our efforts on other potential therapeutic options," says Dr. Clark. "We do know that many patients are drinking well below the recommended amounts. More research is needed, but the goal would be to tailor increased as a treatment to those ."

The hope is to increase the personalized options of effective treatments available in order to reduce the risk of progression to .

Explore further: First drug approved for most common inherited kidney disease

Related Stories

First drug approved for most common inherited kidney disease

April 24, 2018
The U.S. Food and Drug Administration has approved the first drug to slow kidney decline in patients with the most common inherited kidney disease.

New clinical trial using water to treat polycystic kidney disease

January 29, 2018
A cheap, safe and effective treatment to polycystic kidney disease may soon be available, thanks to a new national clinical out of Westmead, Australia, which is trialing water to treat the disease.

Kidney-brain connection may help drive chronic kidney disease

January 29, 2015
In addition to affecting blood pressure, high-salt intake can promote kidney function decline in patients with chronic kidney disease. A study appearing in an upcoming issue of the Journal of the American Society of Nephrology ...

New findings on tolvaptan as autosomal dominant polycystic kidney disease treatment

November 5, 2017
A phase 3 trial studying the effects of tolvaptan has found that the drug slowed the rate of decline in kidney function in patients with the most common form of polycystic kidney disease, a condition with no cure. The results ...

Insomnia linked with early death and kidney dysfunction

November 3, 2017
Insomnia may have detrimental effects on individuals' kidney health and their overall survival, according to a study that will be presented at ASN Kidney Week 2017 October 31-November 5 at the Ernest N. Morial Convention ...

New biomarkers help predict outcomes in diabetic kidney disease

May 8, 2017
A common complication of type 2 diabetes occurs when filters within the kidney are damaged, leading to an abnormal buildup of protein in urine and a decline in kidney function. This condition, called diabetic kidney disease, ...

Recommended for you

New hope for cystic fibrosis

October 19, 2018
A new triple-combination drug treatment being trialled at the Mater Hospital in Brisbane could increase the life expectancy of patients with cystic fibrosis.

Bug guts shed light on Central America Chagas disease

October 18, 2018
In Central America, Chagas disease, or American trypanosomiasis, is spread by the "kissing bug" Triatoma dimidiata. By collecting DNA from the guts of these bugs, researchers reporting in PLOS Neglected Tropical Diseases ...

Rapid genomic sequencing of Lassa virus in Nigeria enabled real-time response to 2018 outbreak

October 18, 2018
Mounting a collaborative, real-time response to a Lassa fever outbreak in early 2018, doctors and scientists in Nigeria teamed up with researchers at Broad Institute of MIT and Harvard and colleagues to rapidly sequence the ...

Researchers cure drug-resistant infections without antibiotics

October 17, 2018
Biochemists, microbiologists, drug discovery experts and infectious disease doctors have teamed up in a new study that shows antibiotics are not always necessary to cure sepsis in mice. Instead of killing causative bacteria ...

Infectious disease consultation significantly reduces mortality of patients with bloodstream yeast infections

October 17, 2018
In a retrospective cohort study conducted at the University of Alabama at Birmingham Division of Infectious Diseases, patients with candidemia—a yeast infection in the bloodstream—had more positive outcomes as they relate ...

How drug resistant TB evolved and spread globally

October 17, 2018
The most common form of Mycobacterium tuberculosis (TB) originated in Europe and spread to Asia, Africa and the Americas with European explorers and colonialists, reveals a new study led by UCL and the Norwegian Institute ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.