• Eiji Higashihara, Kikuo Nutahara, Mitsuhiro Tanbo, Hidehiko Hara, Isao Miyazaki, Kuninori Kobayashi, and Toshiaki Nitatori.
• Department of ADPKD Research, Kyorin University School of Medicine, Tokyo, Japan Department of Urology, Kyorin University School of Medicine, Tokyo, Japan.
• Nephrol. Dial. Transplant. 2014 Sep 1;29(9):1710-9.

BackgroundThe clinical effects of increased water intake on autosomal dominant polycystic kidney disease (ADPKD) progression are unknown.MethodsADPKD patients with creatinine clearance ≧ 50 mL/min/1.73 m(2) were divided into high (H-, n = 18) and free (F-, n = 16) water-intake groups, mainly according to their preference. Prior to the study, 30 patients underwent annual evaluation of total kidney volume (TKV) and 24-h urine for an average of 33 months. During the 1-year study period, TKV and 24-h urine were analyzed at the beginning and end of the study and every 4 months, respectively.ResultsDuring the pre-study period, urine volume (UV) in the H-group was higher (P = 0.034), but TKV and kidney function and their slopes were not significantly different between the two groups. After the study commenced, UV further increased (P < 0.001) in the H-group but not in the F-group. During the study period, TKV and kidney function slopes were not significantly different between the two groups (primary endpoint). Plasma copeptin was lower (P = 0.024) in the H-group than in the F-group. TKV and kidney function slopes became worse (P = 0.047 and 0.011, respectively) after high water intake (H-group) but not in the F-group. High UV was associated with increased urine sodium, and urine sodium positively correlated with the % TKV slope (P = 0.014).ConclusionsAlthough the main endpoint was not significant, high water intake enhanced disease progression in the H-group when compared with the pre-study period. These findings necessitate a long-term randomized study before drawing a final conclusion.© The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA.

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