Urine Volume and Change in Estimated GFR in a Community-Based Cohort Study

Clark, William F.; Sontrop, Jessica M.; Macnab, Jennifer; Suri, Rita S.; Moist, Louise; Salvadori, M; Garg, Amit X.

doi:10.2215/cjn.01990211

Cited by 161 publications

(161 citation statements)

References 39 publications

(42 reference statements)

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“…Changes in eGFR per year during the study period were estimated using within-patient linear regression. A rapid decline in eGFR was defined as a decrease in eGFR (negative slope) of $5% per year (12) over the period baseline to 2 years.…”

Section: Methodsmentioning

confidence: 99%

Albuminuria and Rapid Loss of GFR and Risk of New Hip and Pelvic Fractures

Barzilay

Gao

Clase

et al. 2013

Clinical Journal of the American Society of Nephrology

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Summary Background and objectives The microvascular circulation plays an important role in bone health. This study examines whether albuminuria, a marker of renal microvascular disease, is associated with incident hip and pelvic fractures. Design, setting, participants, & measurements This study reanalyzed data from the Ongoing Telmisartan Alone and in combination with Ramipril Global End Point Trial/Telmisartan Randomized Assessment Study in Angiotensin-Converting Enzyme Intolerant Subjects with Cardiovascular Disease trials, which examined the impact of renin angiotensin system blockade on cardiovascular outcomes (n=28,601). Albuminuria was defined as an albumin-to-creatinine ratio≥30 mg/g (n=4597). Cox proportional hazards models were used to determine the association of albuminuria with fracture risk adjusted for known risk factors for fractures, estimated GFR, and rapid decline in estimated GFR (≥5%/yr). Results There were 276 hip and pelvic fractures during a mean of 4.6 years of follow-up. Participants with baseline albuminuria had a significantly increased risk of fracture compared with participants without albuminuria (unadjusted hazard ratio=1.62 [1.22, 2.15], P<0.001; adjusted hazard ratio=1.36 [1.01, 1.84], P=0.05). A dose-dependent relationship was observed, with macroalbuminuria having a large fracture risk (unadjusted hazard ratio=2.01 [1.21, 3.35], P=0.007; adjusted hazard ratio=1.71 [1.007, 2.91], P=0.05) and microalbuminuria associating with borderline or no statistical significance (unadjusted hazard ratio=1.52 [1.10, 2.09], P=0.01; adjusted hazard ratio=1.28 [0.92, 1.78], P=0.15). Estimated GFR was not a predictor of fracture in any model, but rapid loss of estimated GFR over the first 2 years of follow-up predicted subsequent fracture (adjusted hazard ratio=1.47 [1.05, 2.04], P=0.02). Conclusions Albuminuria, especially macroalbuminuria, and rapid decline of estimated GFR predict hip and pelvic fractures. These findings support a theoretical model of a relationship between underlying causes of microalbuminuria and bone disease.

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Section: Methodsmentioning

confidence: 99%

Albuminuria and Rapid Loss of GFR and Risk of New Hip and Pelvic Fractures

Barzilay

Gao

Clase

et al. 2013

Clinical Journal of the American Society of Nephrology

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“…The water intake should be suffi cient to compensate daily losses (4). An appropriate hydration can reduce the risk of several diseases and physiological disturbances as headaches, obstipation, urolithiasis and renal malfunction (5). However, water consumption habits are complex and receive under-attention when evaluating eating habits (6).…”

Section: Introductionmentioning

confidence: 99%

“…New studies are needed focusing on dietary intake and hydration status (5,6) and the present study aims to contribute to fi ll this research gap in children soccer players.…”

Section: Introductionmentioning

confidence: 99%

Dietary intake according to hydration status in 9-10 year-old soccer players

et al. 2016

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Introduction: Children have an increased risk of voluntary dehydration especially during physical activity which may increase the risk of non-compensating water losses. Objectives: The aim of this study was to assess the hydration status and its relation to food intake in a children group of soccer players. Method: A sample of 36 boys aged 9-10 years was included in this study; 30 completed a 24 h urine collection. Participants completed a 24 h urine collection; a 24 hours food recall corresponding to the day of urine collection was applied, weight and height were measured and parents/caregivers fi lled a lifestyle and socio-demographic questionnaire. The free water reserve (FWR [ml/24 h] = urine volume [ml/24 h] -obligatory urine volume [ml/24 h]) was used to assess the hydration status. Food and beverage groups were created and models of unconditional logistic regression were fi tted in order to estimate the magnitude of the association between the hydration status and diet. Results: Forty three per cent of participants were classifi ed as at risk of hypohydration. Children who reported a high fruit and vegetables intake (above the median) were at decreased risk of hypohydration (OR = 0.19, 95% CI 0.04-0.94, p = 0.041), compared to children who reported a low fruit and vegetables intake. Conclusions: Almost half of the children were at risk of hypohydration. Our results suggested that water food sources such as fruit and vegetables may contribute to euhydration.

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“…Water ingestion, which readily decreases circulating AVP/copeptin levels, may modify CKD progression. 52 Studies in the 5/6 nephrectomized rat model suggested that increased water intake decreases circulating AVP levels and slows down the progression of kidney disease. 53 Taken together, these data suggest that high levels of AVP may be deleterious for kidney function, either by a direct hemodynamic effect through V1a vascular receptors or through V2 tubular receptors.…”

Section: Discussionmentioning

confidence: 99%

Copeptin Is Associated with Kidney Length, Renal Function, and Prevalence of Simple Cysts in a Population-Based Study

Ponte

Pruijm

Ackermann

et al. 2015

Journal of the American Society of Nephrology

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Arginine vasopressin (AVP) has a key role in osmoregulation by facilitating water transport in the collecting duct. Recent evidence suggests that AVP may have additional effects on renal function and favor cyst growth in polycystic kidney disease. Whether AVP also affects kidney structure in the general population is unknown. We analyzed the association of copeptin, an established surrogate for AVP, with parameters of renal function and morphology in a multicentric population-based cohort. Participants from families of European ancestry were randomly selected in three Swiss cities. We used linear multilevel regression analysis to explore the association of copeptin with renal function parameters as well as kidney length and the presence of simple renal cysts assessed by ultrasound examination. Copeptin levels were log-transformed. The 529 women and 481 men had median copeptin levels of 3.0 and 5.2 pmol/L, respectively (P,0.001). In multivariable analyses, the copeptin level was associated inversely with eGFR (b=22.1; 95% confidence interval [95% CI], 23.3 to 20.8; P=0.002) and kidney length (b=21.2; 95% CI, 21.9 to 20.4; P=0.003) but positively with 24-hour urinary albumin excretion (b=0.11; 95% CI, 0.01 to 0.20; P=0.03) and urine osmolality (b=0.08; 95% CI, 0.05 to 0.10; P,0.001). A positive association was found between the copeptin level and the presence of renal cysts (odds ratio, 1.6; 95% CI, 1.1 to 2.4; P=0.02). These results suggest that AVP has a pleiotropic role in renal function and may favor the development of simple renal cysts. The antidiuretic hormone arginine vasopressin (AVP) plays an essential role in osmoregulation by facilitating water transport in the collecting duct. 1 This effect is mediated by the stimulation of the G protein-coupled vasopressin V2 receptor (V2R), increasing cAMP levels and leading to a transient increase in osmotic water transport across the principal cells. 2 Furthermore, it was recently demonstrated that V2Rs are also expressed in the thick ascending limb of the human kidney. 3,4 In addition to the V2R, AVP acts on the V1a receptor (Ca 2+ as second messenger), which is distributed in the endothelial cells lining systemic and renal blood vessels and capillaries (including vasa recta), as well as the glomerulus, the macula densa, the medullary interstitial cells, and the cortical collecting duct. [5][6][7] Of note, V1a receptors seem to

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Urine Volume and Change in Estimated GFR in a Community-Based Cohort Study

Cited by 161 publications

References 39 publications

Albuminuria and Rapid Loss of GFR and Risk of New Hip and Pelvic Fractures

Albuminuria and Rapid Loss of GFR and Risk of New Hip and Pelvic Fractures

Dietary intake according to hydration status in 9-10 year-old soccer players

Copeptin Is Associated with Kidney Length, Renal Function, and Prevalence of Simple Cysts in a Population-Based Study

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