Hydration and Chronic Kidney Disease Progression: A Critical Review of the Evidence

We performed a comprehensive literature review to examine evidence on the effects of hydration on the kidney. By reducing vasopressin secretion, increasing water intake may have a beneficial effect on renal function in patients with all forms of chronic kidney disease (CKD) and in those at risk of CKD. This potential benefit may be greater when the kidney is still able to concentrate urine (high fluid intake is contraindicated in dialysis-dependent patients). Increasing water intake is a well-accepted method for preventing renal calculi, and current evidence suggests that recurrent dehydration and heat stress from extreme occupational conditions is the most probable cause of an ongoing CKD epidemic in Mesoamerica. In polycystic kidney disease (PKD), increased water intake has been shown to slow renal cyst growth in animals via direct vasopressin suppression, and pharmacologic blockade of renal vasopressin-V2 receptors has been shown to slow cyst growth in patients. However, larger clinical trials are needed to determine if supplemental water can safely slow the loss of kidney function in PKD patients. © 2016 S. Karger AG, Basel Published online: May 3, 2016 Nephrology American Journal of Dr. William F. Clark Division of Nephrology, Department of Medicine Victoria Hospital 800 Commissioner’s Road East A2-343, London ON N6A 5W9 (Canada) E-Mail William.Clark @ lhsc.on.ca © 2016 S. Karger AG, Basel 0250–8095/16/0434–0281$39.50/0 www.karger.com/ajn The Cordeliers Research Center (CRC) was established in 2007 under the direction and under the impetus of Professor Hervé Fridman, specialist in clinical immunology, under the joint supervision of the National Institute of Health and medical research (INSERM), University Pierre et Marie Curie, University Paris Descartes and in connection with the National Centre for Scientific research (CNRS), Paris Diderot University and the Ecole Pratique des Hautes Etudes.